经阴道局部病灶切除术治疗剖宫产瘢痕部位妊娠40例

摘要

Objective:To observe the effects of transvaginal local lesion resection and uterine curettage in the treatment of cesarean scar pregnancy .Methods:40 patients were cured by transvaginal local lesion resection .30 patients in control group were received uterine curettage under hysteroscopy after embolization of bilateral uterine ar‐teries ,After the treatment ,the vaginal bleeding was measured in surgery ,we observed the hospitalization days be‐tween groups ,and the reduction of serum beta‐human chorionic gonadotropin (β‐HCG) 7 days after the treatment was evaluated .Results :The amount of vaginal bleeding in control group was 143 ± 60 ml ,and that in observed group was significantly reduced as was 50 ± 24ml .The change of β‐HCG was Respectively 0 .52 ± 0 .24 in control group and 0 .8 ± 0 .13 in observed group .There was statistical differences in the change of β‐HCG Between groups .Average hospitalization days in observed group was 4 .7 ± 2 .4 days which was significantly shortened ,compared with 7 .2 ± 3 . 1 days in control group .Conclusion :Transvaginal local lesion resection appeared the advantages of less bleeding ,bet‐ter effects and shortened hospitalization days .It is a safe and effective treatment in Patients with Cesarean Scar Preg‐nancy .%目的：观察经阴道局部病灶切除术治疗子宫瘢痕部妊娠的安全性及有效性。方法：40例子宫瘢痕部位妊娠患者经阴道行局部病灶切除术为治疗组，30例给予双侧子宫动脉栓塞后行宫腔镜下清宫术的患者作为对照组。观察两组术中出血量、住院天数及术后1周β‐HCG水平变化。结果：治疗组术后1周血清β‐HCG下降幅度为0．8±0．13，对照组为0．52±0．24；术中出血量治疗组平均为50±24 ml ，对照组为143±60 ml；平均住院日治疗组为4．7±2．4 d ，对照组为7．2±3．1 d。两组比较差异均有统计学意义（P＜0．05）。结论：经阴道局部病灶切除术治疗子宫瘢痕部妊娠具有安全性高、术中出血少、住院天数短等、术后恢复快等优点。