何文姝

[摘要]目的 探讨宫腔镜在剖宫产瘢痕妊娠和宫颈妊娠治疗中的应用价值。方法 选取2016年6月～2017年6月我院收治的100例剖宫产瘢痕妊娠和宫颈妊娠患者作为研究对象，按照就诊日期的单双数将其分为观察组与对照组，每组各50例。观察组给予宫腔镜治疗，对照组采取最为传统的简单治疗方式，观察比较两组的HCG水平、术中出血量、子宫恢复时间以及术后并发症的发生率。结果 观察组人绒毛膜促性腺激素（HCG）水平为（15 333.53±143.32）U/L、术中出血量（296.92±24.21）ml、子宫恢复时间（14.64±2.42）d以及住院期间并发症的发生率（8.00%）明显低于对照组HCG水平[（27 536.37±116.46）U/L]、术中出血量[（382.42±21.37）ml]、子宫恢复时间[（25.49±2.73）d]以及住院期间并发症总发生率（36.00%），差异均有统计学意义（P<0.05）。结论 对剖宫产瘢痕妊娠和宫颈妊娠患者，将宫腔镜手术治疗用于临床治疗，能有效降低患者在手术中的出血量，缩短患者子宫恢复的时间，降低患者的HCG水平，大大降低了患者在住院治疗期间发生并发症的风险，值得在临床上推广。

[关键词]宫腔镜；剖宫产；宫颈妊娠

[中图分类号] R714.22 [文献标识码] A [文章编号] 1674-4721（2018）7（b）-0088-03

[Abstract] Objective To investigate the value of hysteroscopy in the treatment of cervical pregnancy in cesarean section. Methods From June 2016 to June 2017， 100 cases of cesarean cervical pregnancy admitted in our hospital were selected as the research object. According to the single and double numbers of the treatment date， they were divided into observation group and control group， 50 cases in each group. Patients in the observation group were treated with hysteroscopy. The control group was treated with the most simple and simple method. HCG levels， intraoperative blood loss， uterine recovery time and the incidence of postoperative complications were compared between the two groups. Results The levels of HCG （[15 333.53±143.32] U/L）， blood loss in operation （[296.92±24.21] ml）， time of uterine recovery （14.64±2.42） d， and the total incidence of complication during hospitalization in hysteroscopic surgery group （8%） was significantly lower than that of the control group （[27 536.37±116.46] U/L）， blood loss （[382.42±21.37] ml）， uterine recovery time [25.49±2.73] d） and the incidence of complications （36.00%）. All the data in the table were statistically significant after analysis （P<0.05）. Conclusion For patients undergoing cesarean section with cervical pregnancy treated in our hospital， hysteroscopic surgical treatment is applied to the clinical treatment process， which can effectively reduce the amount of bleeding during operation， shorten the recovery time of the uterus and reduce HCG level in patients， greatly reducing the patients′ risk of complications during hospitalization， it is worth in the clinical promotion.

[Key words] Hysteroscopy； Cesarean section； Cervical pregnancy

剖宮产瘢痕妊娠和宫颈妊娠[1]均属于异位妊娠，虽然在临床上较为少见，发生率不高，但是剖宫产瘢痕妊娠和宫颈妊娠患者的病情比较严重，极易出现大出血的症状，甚至可能出现子宫破裂，严重者需切除子宫治疗，而绝大部分患者均属于育龄期，对切除子宫治疗无法接受，极易出现焦虑、恐慌及担忧的负性情绪，对患者的日常生活及工作造成十分严重的影响[2-3]。目前临床上对剖宫产瘢痕妊娠和宫颈妊娠患者主要是采取清宫术以及子宫动脉栓塞术进行治疗，但取得的临床治疗效果常不满意，如何采取一种有效的治疗方法，对剖宫产瘢痕妊娠和宫颈妊娠患者进行治疗，以提升临床治疗效果，一直是临床研究的重点[4-5]。……