宫腔镜联合腹腔镜诊治子宫切口妊娠在基层医院的临床价值

目的 探讨宫腔镜联合腹腔镜对子宫切口妊娠的诊治价值,并分析影响治疗的因素.方法 回顾性分析2009年1月～2012年12月经官腹腔镜联合诊治的子宫切口妊娠患者40例,分析患者手术及术后情况以及影响手术效果的因素.结果 一次性治疗成功36例,失败4例.患者平均手术时间(60±14.2)min,术中平均出血量(114±41.7)mL,单因素分析显示患者年龄、对手术影响无意义(P＞0.05).停经天数,血β-HCG水平及包块最大径是影响手术效果的关键因素(P＜0.05).结论 宫腹腔镜联合治疗子宫切口妊娠,显示出手术创伤小、术后恢复快、治疗成功率高、依从性好的优点,值得临床广泛开展.

Clinical value of combination with hysteroscopy and laparoscopy in the diagnosis and treatment of cesarean scar pregnancy in basic hospital

Objective To investigate the value of hysteroscopy combined with laparoscopy in the diagnosis and treat- ment of cesarean scar pregnancy, and analyze the influence factors of treatment. Methods Retrospective analysis of 40 cases with cesarean scar pregnancy in Jan. 2009 to Dec. 2012 were treatmented by laparoscopy combined with hys- teroscopy, Understand the surgery and postoperative and analyse the influencing factors of surgical results. Results 36 cases were successfully treated, 4 cases failed. The average operation time （45.1±14.2） minutes, average bleeding volume during operation （114.5±41.7） mL, 13 -HCG blood clearance time （19.1±6.4） days, mass absorption time （54.1±10.4） days. Univariate analysis showed that patient age, menopausal days no significance to the operation ef- fect （P 〉 0.05）. Serum -HCG level and mass diameter are the key factors to influence the effect of operation （P 〈 0.05）. Conclusion Laparoscopy combined with hysteroscopy in treatment of cesarean scar pregnancy, showed a short operation time, operation little trauma, faster postoperative recovery, treatment success rate high, the advantages of good compliance, is worthy of extensive development.