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目的:探讨宫腔镜联合自制水囊压迫法在治疗剖宫产瘢痕部位妊娠中的临床价值。方法:选择2013年11月-2015年11月期间,我院收治的剖宫产瘢痕部位妊娠(CSP)患者30例作为研究对象,随机分为观察组及对照组各15例,回顾性分析住院时的临床资料,入院后予米非司酮口服,对照组行B超监测,在促宫缩治疗同时行清宫术,观察组在宫腔镜联合B超监测下行清宫术或行妊娠内容物电切术,术后于宫腔内放置自制水囊压迫止血,24小时内取出水囊。结果:观察比较两组患者的手术成功率、手术时间、术中出血量、输血量、放置水囊压迫止血时的平均出血量、子宫切除率、并发症(二次宫腔镜手术、子宫穿孔、感染、子宫坏死等)、血β-hCG下降至正常水平时间、子宫恢复正常大小时间、随访(月经复潮时间、子宫疤痕切口愈合情况),结果显示,观察组明显优于对照组,手术成功率达100%,对照组有2例行双侧子宫动脉栓塞术,成功率98%,两组均无并发症的发生,差异具有统计学意义(P<0.05)。结论:剖宫产瘢痕部位妊娠清宫术中易发生大出血,我院应用宫腔镜联合水囊压迫法治疗剖宫产瘢痕部位妊娠,疗效确切,值得在临床上推广应用。
Objective: To investigate the clinical value of hysteroscopy combined with homemade balloon compression in the treatment of cesarean section scar pregnancy. Methods: From November 2013 to November 2015, 30 patients with cesarean scar pregnancy (CSP) in our hospital were selected as study subjects and randomly divided into observation group and control group with 15 cases each. The retrospective analysis of hospitalization When clinical data, after admission to mifepristone orally, the control group B-monitoring, curettage at the same time curettage, observation group under hysteroscopy combined with B-monitoring curettage or pregnancy content of electricity Incision, placed in the uterine cavity after the homemade balloon compression hemostasis, remove the water sac within 24 hours. Results: The success rates of operation, operation time, intraoperative blood loss, blood transfusion, blood loss during hysteroplasty, hysterectomy rate, complications (secondary hysteroscopy, uterine perforation , Infection, uterine necrosis, etc.), blood β-hCG decreased to normal time, uterus returned to normal size and time, follow-up (menstrual resurgence time, uterine scar incision healing), the results showed that the observation group was significantly better than the control group The success rate was 100%. There were 2 cases of bilateral uterine artery embolization in the control group, the success rate was 98%. There was no complication in both groups. The difference was statistically significant (P <0.05). Conclusion: Cesarean section scar pregnancy prone to bleeding during surgery, hysteroscopy and hydatidiform obstruction in our hospital for treatment of cesarean section scar pregnancy, the exact effect, it is worth in the clinical application.