宫腔镜下清宫术治疗剖宫产术后瘢痕妊娠疗效观察

目的探讨宫腔镜下清宫术治疗剖宫产术后瘢痕妊娠(CSP)的临床疗效。方法 50例CSP患者按治疗方法分为4组,A组10例患者给予药物治疗后行宫腔镜下清宫术;B组6例患者行子宫动脉栓塞术后再行宫腔镜下清宫术;C组23例患者给予药物治疗后行常规清宫术;D组11例患者行子宫动脉栓塞术后再行常规清宫术。比较4组患者术中出血量、手术时间、术后2次清宫率、住院时间及住院费用。结果 A、B组患者术中出血量显著少于C、D组,A、B组患者手术时间和住院时间短于C、D组,但A、B组患者住院费用高于C、D组,差异均有统计学意义(P<0.05)。A、B、C、D组患者术后2次清宫率分别为0.0%(0/10)、0.0%(0/6)、17.4%(4/23)和9.1%(1/11),A、B组患者术后2次清宫率显著低于C、D组,差异有统计学意义(P<0.05)。结论宫腔镜下清宫术治疗CSP具有术中出血量少、手术时间和住院时间短及2次清宫率低等特点,但住院费用相对较高。

Effect of curettage of uterus under hysteroscope on cesarean scar pregnancy

Objective To discuss the clinical effect of curettage of uterus under hysteroscope on cesarean scar pregnancy（CSP）. Methods Fifty patients with CSP were divided into four groups according to therapeutic method. Ten patients in group A were treated with curettage of uterus under hysteroscope after drug treatment, six patients in group B were treated with curettage of uterus under hysteroscope after uterine arterial embolization, twenty-three patients in group C were treated with conventional curettage of uterus after drug treatment, eleven patients in group D were treated with conventional curettage of uterus after uterine arterial embolization. The intraoperative bleeding volume, operation time, the second curettage of uterus rate, hospitalization time and cost of hospitalization were compared among the four groups. Results The intraoperative bleeding volume in group A and B was significantly less than that in group C and D（P 〈 0.05）. The operation time and hospitalization time in group A and B were significantly shorter than those in group C and D （P 〈 0.05 ）. But the cost of hospitalization in group A and B was significantly higher than that in group C and D （P 〈 0.05 ）. The rate of the second curettage of uterus in group A, B, C and D was 0.0% （0/10） ,0.0% （0/6） ,17.4% （4/23） and 9.1% （ 1/11 ） ,respectively. The rate of the second curettage of uterus in group A and B was significantly lower than that in group C and D （ P 〈 0.05 ）. Conclusions Curettage of uterus under hysteroscope for treating CSP has characteristics of less intraoperative bleeding value, short operation time and hospitalization time. and low rate of the second curettage of uterus. But the cost of hosnitalizntinn is relatively hi~h_