DU Xiumei. Two treatment methods for cesarean scar pregnancy: a clinical analysis[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2019, 49(11): 850-852，,856.
摘要目的：分析经阴道和经腹腔镜2种方式治疗剖宫产术后子宫瘢痕妊娠（CSP）的临床效果和安全性。方法：选取2016年1月至2018年12月在徐州市贾汪区人民医院治疗的76例CSP患者，按手术方式的不同分为经阴道手术组（A组）与经腹腔镜手术组（B组），每组各38例。A组采用经阴道子宫下段病灶切除术进行治疗，B组采用腹腔镜下病灶切除术进行治疗，比较2组患者的手术时间、出血量、住院时间、首次肛门排气时间、月经恢复时间、血清人绒毛膜促性腺激素（β-HCG）恢复时间、术后24 h VAS评分，记录膀胱损伤、阴道流血、感染等并发症发生情况。结果：A组的手术时间、出血量及住院时间均少于B组，差异有统计学意义（P＜0.05），A组的首次肛门排气时间及术后24 h VAS均少于B组，差异有统计学意义（P＜0.05），但2组的月经恢复时间及血清β-hCG恢复时间的差异无统计学意义（P＞0.05），2组并发症发生情况差异无统计学意义（P＞0.05）。结论：经阴道以及经腹腔镜2种方式对CSP患者均具有良好的临床效果和安全性。经阴道手术的优势在于创伤更小，术后患者恢复更快。
Abstract：Objective: To analyze the clinical effect and safety of trans-vaginal and laparoscopic treatment of cesarean scar pregnancy (CSP). Methods: 76 CSP patients treated in our hospital from January 2016 to December 2018 were divided as Transvaginal Operation Group (Group A) and Laparoscopic Operation Group (Group B), with 38 cases in each group. Group A underwent transvaginal hysterectomy and Group B underwent laparoscopic hysterectomy. The operation time, bleeding volume, hospital stay, first anal exhaust time, menstrual recovery time, recovery time of serum human chorionic gonadotropin (β-HCG), 24-hour visual analogue score (VAS) were compared between the two groups. The occurrence of bladder injury, vaginal bleeding, infection and other complications were recorded. Results: The operation time, bleeding volume and hospitalization time were significantly less (P<0.05) in Group A than in Group B. The first anal exhaust time and 24-hour VAS of group A were less than those of group B, the difference being statistically significant (P<0.05). There was no significant difference between the two groups (P>0.05) in menstrual recovery time, serum β-hCG recovery time as well as the occurrence of complications. Conclusion: Both transvaginal and laparoscopic approaches are effective and safe for CSP patients. However, transvaginal surgery has the advantages of less trauma and faster recovery.
