经阴道手术治疗剖宫产瘢痕部位妊娠的临床效果分析

目的分析经阴道手术治疗剖宫产瘢痕部位妊娠(CSP)的临床效果。方法选取CSP患者78例,采用随机数字表法将其分为对照组(n=39,行宫腔镜下清宫及瘢痕妊娠病灶电切术)和观察组(n=39,经阴道手术)。比较两组治疗效果、手术相关指标及血清β-人绒毛膜促性腺激素(β-hCG)水平。结果观察组的治疗成功率为97.44%,高于对照组的74.36%(P<0.05)。观察组手术时间长于对照组,术中出血量、住院费用、住院时间少/短于对照组(均P<0.05)。术后1 d、3 d、7 d、14 d观察组的血清β-hCG水平均低于对照组(F_组间=6 239.000,P_组间<0.001),两组的血清β-hCG水平均有随时间变化而降低的趋势(F_时间=167.300,P_时间<0.001),分组与时间有交互效应(F_交互=75.040,P_交互<0.001)。结论经阴道手术治疗CSP的临床效果显著,能够快速使血清β-hCG水平降至正常,手术治疗成功率高,具有较高的临床应用价值。

Transvaginal surgery in the treatment of cesarean scar pregnancy:an analysis of the clinical effect

Objective To analyze the clinical effects of transvaginal surgery in treating cesarean scar pregnancy(CSP).Methods A total of 78 CSP patients were selected,and they were divided into control group(n=39,undergoing evacuation of uterus via hysteroscope and scar pregnancy electrical resection of the lesions)and observation group(n=39,undergoing transvaginal surgery)by the random number table method.The therapeutic effect,surgical related indicators and serumβ-human chorionic gonadotropin(β-hCG)level were compared between the two groups.Results The treatment success rate in the observation group was 97.44%,which was higher than that in the control group(74.36%)(P<0.05).The observation group yielded longer surgery duration,whereas less intraoperative blood loss volume and hospital expenses,and shorter hospital stays(all P<0.05).After 1 d,3 d,7 d and 14 d of surgery,the serumβ-hCG level in the observation group was lower than that in the control group(F intergroup=6239.000,P intergroup<0.001),and the serumβ-hCG level in both groups interpreted a trend of decreasing over time(F time=167.300,P time<0.001).The grouping had interaction effect with time(F interaction=75.040,P interaction<0.001).Conclusion Transvaginal surgery for CSP has a significant clinical effect,which can quickly decrease serumβ-hCG to the normal level,and improve the success rate of surgery,and thus it has a high clinical application value.