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目的探讨经阴道子宫瘢痕妊娠病灶切除术治疗剖宫产术后瘢痕妊娠(CSP)的临床疗效及对患者生活质量的影响。方法选取CSP患者60例,30例血清人绒毛膜促性腺激素(β-hCG)<6 000 U/L或包块直径≤30 mm者随机分为观察A组与对照A组,每组15例,分别予以经阴道子宫瘢痕妊娠病灶切除术、药物联合清宫治疗;30例血清β-hCG≥6 000 U/L或包块直径31~50 mm者随机分为观察B组与对照B组,每组15例,分别予以经阴道子宫瘢痕妊娠病灶切除术、介入治疗联合清宫。观察和比较各组治疗后第1、4、7、14天时血清β-hCG下降率、住院情况及生活质量评分。结果观察A组及观察B组治疗后第1、4、7、14天血清β-hCG下降率及治疗后3个月生活质量评分均分别显著高于对照A组及B组(P<0.05),总出血量、住院时间、血清β-hCG复常时间及月经复常时间均显著低于对照A组与B组(P<0.05)。结论经阴道子宫瘢痕妊娠病灶切除术治疗CSP具有疗效确切、安全可靠、术后康复快等优点,能够改善患者的术后生活质量,可作为首选治疗方式。
Objective To investigate the clinical efficacy of transvaginal cesarean scar excision for cesarean scar pregnancy (CSP) and its impact on the quality of life of patients. Methods Sixty patients with CSP and 30 patients with serum human chorionic gonadotropin (β-hCG) <6 000 U / L or masses ≤30 mm were randomly divided into observation group A and control group A, with 15 cases in each group , Were treated by transvaginal cesarean scar excision of pregnancy, drug combination of curettage; 30 cases of serum β-hCG ≥ 6000 U / L or mass 31 to 50 mm were randomly divided into observation group B and control group B Group of 15 cases were treated by transvaginal cesarean scar excision, interventional treatment combined with Qing Palace. The decreasing rate of β-hCG, hospitalization and quality of life on the 1st, 4th, 7th and 14th days after treatment were observed and compared. Results The decrease rate of serum β-hCG on the 1st, 4th, 7th and 14th days after treatment and the quality of life 3 months after the treatment in the observation group A and B were significantly higher than those in the control group A and B (P <0.05) , Total bleeding, length of hospital stay, serum β-hCG recovery time and menstruation recovery time were significantly lower than those in control A and B groups (P <0.05). Conclusions Transvaginal uterine scar pregnancy resection for CSP has the advantages of definite curative effect, safe and reliable, quick recovery after operation and so on, which can improve postoperative quality of life of patients and can be used as the first choice of treatment.