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目的比较两种术式治疗剖宫产术后瘢痕妊娠的临床疗效。方法 2014年6月-2015年10月期间收纳的33例剖宫产术后瘢痕妊娠者,随机分为两组,A组17例,行子宫动脉化疗栓塞+宫腔镜切除瘢痕妊娠病灶,B组16例,行开腹手术切除子宫瘢痕妊娠病灶。记录所有患者手术出血量、手术时间、住院时间、术后β-h CG恢复至正常时间及术后6个月内的并发症情况。结果与A组相比,B组的手术出血量较多,手术时间、住院时间和术后恢复至正常β-h CG时间均较长(P<0.05)。结论瘢痕子宫妊娠一经确诊应尽快终止妊娠,治疗方案的制定要考虑妊娠囊类型、生育要求等。如果病情稳定,且医院软硬件配套情况下,可采用UAC+宫腔镜切除瘢痕妊娠病灶,可达到治疗周期短和效果确切的作用。对于外生型的瘢痕子宫妊娠或伴有不同程度的其他妇科病者,可采用开腹手术治疗。
Objective To compare the clinical effects of two kinds of surgical treatment of scar pregnancy after cesarean section. Methods From June 2014 to October 2015, 33 cases of cesarean scar pregnancy were randomly divided into two groups: group A, 17 cases underwent uterine artery chemoembolization and hysteroscopic resection of scar pregnancy, B Group of 16 patients underwent open abdominal surgery to remove uterine scar pregnancy lesions. All patients undergoing surgery were recorded bleeding, operation time, hospital stay, postoperative β-h CG recovery to normal time and postoperative complications within 6 months. Results Compared with group A, group B had more operation bleeding, and the operation time, hospital stay and recovery to normal β-h CG were longer (P <0.05). Conclusion Once the scar pregnancy has been diagnosed, the pregnancy should be terminated as soon as possible. The formulation of the treatment plan should consider the type of pregnancy capsule and the requirements of childbirth. If the condition is stable, and the hospital software and hardware support cases, UAC + hysteroscopic scar pregnancy can be removed, the treatment cycle can be short and the exact effect. For exogenous cicatricial uterine pregnancy or with varying degrees of other gynecological diseases, can be used laparotomy.