陈琳

[摘要] 目的 分析经阴道切除Ⅱ型剖宫产术后子宫切口疤痕妊娠的临床效果。 方法 该文方便选取2015年6月—2017年3月来该院接受疤痕妊娠治疗的患者90例，随机分成对照组和观察组，每组患者45例，对照组采用清宫术，观察组采用经阴道子宫疤痕妊娠病灶切除Ⅱ型剖宫产术。 结果 观察组患者出血量、术后血β-HCG转阴时间、术后月经来潮时间、术后彩超测子宫下段肌层厚度、手术时间、住院时间治疗疗效相对于对照组较好；观察组患者总治療有效率为100.00%，对照组为80.00%，观察组治疗有效率高于对照组；治疗满意度对比观察组高于对照组，差异有统计学意义（P<0.05）。结论 经阴道切除剖宫产疤痕妊娠在治疗Ⅱ型剖宫产术后子宫切口疤痕妊娠中，提升了患者术后恢复情况及治疗效果。

[关键词] 阴道；剖宫产；子宫切口；疤痕妊娠

[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2018）02（a）-0071-03

Transvaginal Resection of Type Ⅱ Cesarean Section after Uterine Incision Scar Pregnancy

CHEN Lin

Department of Gynaecology， Chongqing Medical University Affiliated Nanchuan Peoples Hospital， Chongqing， 408400 China

[Abstract] Objective This paper tries to analyze the clinical effect of transvaginal hysterectomy after cesarean uterine scar pregnancy. Methods 90 cases of scar pregnancy patients from June 2015 to March 2017 in our hospital for treatment were convenient selected and randomly divided into control group and observation group， with 45 cases in each group， the control group used curettage， the observation group adopted the uterine scar pregnancy by transvaginal resection of type II cesarean section. Results Patients with bleeding time， blood beta -HCG negative postoperative menstruation time after surgery， postoperative ultrasound measurement of the lower uterine segment thickness， operation time， hospitalization time effect treatment， compared with the control group， the observation group was better； the total effective rate of observation group was 100.00% and 80.00% in the control group， The effective rate of the observation group was higher than that of the control group， and the contrast observation group of the treatment satisfaction was higher than the control group， the difference was statistically significant （P< 0.05）. Conclusion Transvaginal cesarean section scar pregnancy in the treatment of type Ⅱ cesarean section after uterine incision scar pregnancy， enhance the patients recovery and treatment.

[Key words] Vagina； Cesarean section； Uterine incision； Scar pregnancy

剖宫切口疤痕妊娠（CSP）是异位妊娠中一种罕见的病症类型，为受精卵着床于既往剖宫产瘢痕处的异位妊娠，发病率为1：1 800，占剖宫产术后妊娠的0.045%。在早期阶段，CSP的发病率不高，由于医学技术还不发达，大多数人在生产时会选择顺产，而不是由专业的人员来接生。随着医疗技术的发展，越来越多的选择剖宫产，增加了CSP的发病概率。近年来剖宫产率逐年上升，CSP的发生率呈升高趋势，CSP作为剖宫产的远期并发症，容易出现误诊现象，导致剖宫产手术患者出现大出血和子宫破裂等并发症，如能早诊断、早治疗，有助于减少并发症，保留患者的生育能力。该文于2015年6月—2017年3月将经阴道切除Ⅱ型剖宫产子宫疤痕妊娠病灶作为主要研究对象，分析其在子宫切口疤痕妊娠中的临床效果，现报道如下。……