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目的:分析经阴道子宫瘢痕妊娠切除术治疗32例子宫瘢痕妊娠的临床疗效。方法:选取2012年3月至2014年12月我院妇产科收治的子宫瘢痕妊娠孕妇32例,均行经阴道瘢痕妊娠病灶切除术;术后监测患者血β-HCG水平,记录手术时间、术中出血量、住院时间、住院费用、术后恢复及并发症发生情况。结果:32例经阴道子宫瘢痕妊娠切除术均顺利完成,成功清除胎盘绒毛组织。手术时间25~55min,平均(33.8±5.9)min;术中出血量5~70ml,平均(44.7±10.5)ml;住院时间3~8天,平均(4.2±1.8)天;住院费用5213.9~8471.1元,平均(6153.8±955.7)元。7~28天血β-HCG水平均降至正常范围,平均恢复时间为(16.2±6.3)天;病灶缩小时间为(5.5±1.2)天,月经复潮时间为(34.5±8.9)天。32例患者中有1例出现阴道血肿,无麻醉、感染、持续宫外孕、膀胱阴道瘘等并发症发生。结论:经阴道子宫瘢痕妊娠切除术疗效确切,且具有微创、简单、安全、术后恢复快、并发症少、费用低等优点。
Objective: To analyze the clinical efficacy of transvaginal uterine scar pregnancy in the treatment of 32 cases of uterine scar pregnancy. Methods: From March 2012 to December 2014, 32 pregnant women with uterine scar treated by obstetrics and gynecology in our hospital were enrolled in this study. All patients underwent transvaginal scar pregnancy resection. The level of β-HCG in blood was monitored after operation, and the operation time and operation were recorded In the amount of bleeding, hospital stay, hospitalization costs, postoperative recovery and complications. Results: 32 cases of vaginal uterine scar pregnancy resection were successfully completed, the successful removal of placental villi. The operation time was 25-55 minutes, with an average of (33.8 ± 5.9) minutes. The intraoperative blood loss was 5-70 ml (mean, 44.7 ± 10.5) ml. The duration of hospitalization was 3-8 days (4.2 ± 1.8 days), and the hospitalization cost was 5213.9-8471.1 Yuan, average (6153.8 ± 955.7) yuan. The level of serum β-HCG decreased from 7 to 28 days to the normal range, with an average recovery time of (16.2 ± 6.3) days; the lesion reduction time was (5.5 ± 1.2) days and the menstrual period was (34.5 ± 8.9) days. One of 32 patients had vaginal hematoma, no anesthesia, infection, continuous ectopic pregnancy, vesico-vaginal fistula and other complications. Conclusion: Transvaginal uterine scar pregnancy resection is effective and has the advantages of minimally invasive, simple, safe, quick recovery, less complications and low cost.