不同手术方式治疗Ⅱ型瘢痕妊娠对再次妊娠的影响
Impact of different surgical methods for treating type Ⅱ scar pregnancy on subsequent pregnancies
伍博明 1蓝柳冰2
作者信息
- 1. 514000 广东省梅州市,广东医科大学第一临床学院
- 2. 梅州市人民医院
- 折叠
摘要
目的 分析不同手术方式治疗剖宫产Ⅱ型瘢痕妊娠对再次妊娠的影响.方法 选取2015年8月-2022年3月收治的剖宫产Ⅱ型瘢痕妊娠(CSP)患者284例为研究对象;选择其中行清宫术(彩超监测下或联合宫腔镜)的147例患者为A组;选择行子宫动脉介入栓塞后再行清宫术的73例患者为B组;选择行腹腔镜下子宫瘢痕妊娠物清除+修补术的64例患者为C组.所有患者随访时间2年,比较三组患者的再次妊娠率、再次CSP、异位妊娠、早产流产、足月产等情况.结果 共有174例患者自然妊娠,自然妊娠率为61％,三组患者再次妊娠率比较,差异无统计学意义(P＞0.05).三组患者术后异位妊娠、流产(自然流产和稽留流产)、足月产、再次CSP的发生率比较,差异均无统计学意义(P＞0.05).结论 三种手术方式治疗Ⅱ型子宫瘢痕妊娠均有良好的自然妊娠率,腹腔镜下子宫瘢痕妊娠物清除+修补术治疗Ⅱ型子宫瘢痕妊娠不能减少再次瘢痕妊娠的发生.
Abstract
Objective To analyze the impact of different surgical methods for treating type Ⅱ scar pregnancy in cesarean section on subsequent pregnancies.Methods 284 patients with type Ⅱ scar pregnancy(CSP)who underwent cesarean section from August 2015 to March 2022 were selected as the study subjects;147 patients who underwent curettage surgery(under ultrasound monitoring or combined with hysteroscopy)were selected as Group A;73 patients who underwent uterine artery embolization followed by uterine curettage were selected as Group B;64 patients who underwent laparoscopic uterine scar removal and repair surgery were selected as Group C.All patients were followed up for 2 years to compare the rates of re pregnancy,re CSP,ectopic pregnancy,premature miscarriage,and full-term delivery among the three groups of patients.Results A total of 174 patients had natural pregnancies,with a natural pregnancy rate of 61％.There was no statistically significant difference in the re pregnancy rate among the three groups of patients(P＞0.05).There was no statistically significant difference in the incidence of ectopic pregnancy,miscarriage(natural miscarriage and missed miscarriage),full-term delivery,and recurrent CSP among the three groups of patients after surgery(P＞0.05).Conclusion All three surgical methods for treating type Ⅱ uterine scar pregnancy have good natural pregnancy rates.Laparoscopic removal and repair of uterine scar pregnancy materials cannot reduce the occurrence of recurrent scar pregnancy in type Ⅱ uterine scar pregnancy.
关键词
Ⅱ型瘢痕妊娠/子宫动脉介入栓塞/腹腔镜下子宫瘢痕妊娠物清除+修补术/再次妊娠Key words
Type Ⅱ scar pregnancy/Uterine artery intervention embolization/Laparoscopic removal and repair of uterine scar pregnancy material/Pregnancy again引用本文复制引用
出版年
2024
NETL
NSTL
万方数据