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目的:探讨不同方法治疗剖宫产瘢痕妊娠的临床价值及安全性。方法:纳入我院68例CSP患者作为研究对象,随机抽签分为两组,各34例。两组患者均于术前行双侧子宫动脉甲氨蝶呤100mg注射治疗。观察组采用宫腔镜定位+腹腔镜下子宫瘢痕楔形切除术,对照组采用腹腔镜监测下+宫腔镜下清宫术。比较两组手术基本情况、β-HCG水平及术后并发症。结果:观察组手术时间、术中出血量和住院时间均显著低于对照组(P<0.05);观察组术后第7天、14天β-HCG水平显著低于对照组(P<0.05)。两组患者术后并发症发生率无显著性差异(P>0.05)。结论:宫腔镜定位+腹腔镜下子宫瘢痕楔形切除术具有手术效果理想、术后恢复快、安全性高等特点,值得临床推广。
Objective: To explore the clinical value and safety of different methods for cesarean scar pregnancy. Methods: Sixty-eight patients with CSP admitted to our hospital were randomly divided into two groups (34 in each). Two groups of patients were preoperative bilateral uterine artery methotrexate 100mg injection. The observation group was treated with hysteroscopy and laparoscopic womb excision. The control group was treated with laparoscopy and hysteroscopic curettage. The basic operation, β-HCG level and postoperative complications were compared between the two groups. Results: The operation time, intraoperative blood loss and hospital stay in the observation group were significantly lower than those in the control group (P <0.05). The β-HCG level in the observation group was significantly lower than that of the control group on the 7th and 14th days after operation (P <0.05) . There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusion: Hysteroscopic positioning and laparoscopic womb resection of uterine scar surgery with satisfactory results, postoperative recovery fast, high security, worthy of clinical promotion.