Comparison of the curative effect of laparoscopically monitored uterine clearance in the treatmentof type I and type II uterine scar pregnancy
腹腔镜监护下清宫术对I型、Ⅱ型子宫瘢痕妊娠治疗的疗效比较

摘要

目的 研究腹腔镜监护下清宫术在I型和Ⅱ型子宫瘢痕妊娠患者治疗中的疗效评价。方法 回顾性分析我院2019年7月至2020年9月收治的110例I型、Ⅱ型子宫瘢痕妊娠患者（其中34例I型，76例Ⅱ型），均采用腹腔镜监护下清宫的临床治疗效果。结果 I型CSP患者在本次研究中的成功率为94.1%，Ⅱ型CSP患者成功率为100%。均无严重并发症发生，Ⅱ型CSP患者术中出血量较I型CSP患者在统计学上有差异（P=0.028），而住院时间、手术时间及住院费用比较差异无统计学意义（P＞0.05）。结论 对于I型CSP患者采用腹腔镜监护下清宫治疗手术相对较安全，并发症较少；Ⅱ型CSP患者采用腹腔镜监护下清宫治疗手术手术成功率有一定保障，因术中可再次判断子宫既往瘢痕处病灶情况，且便于子宫瘢痕处病灶大出血情况下的紧急处理。

Abstract

Objective To evaluate the efficacy of laparoscopically monitored curettage in the treatment of type I and type II cesarean scar pregnancy.
Methods 110 cases of type I and type II cesarean scar pregnancy (including 34 cases of type I and 76 cases of type II) admitted to our hospital from July 2019 to September 2020 were retrospectively classified, and all of them were treated with laparoscopically monitored uterine clearance.
Results The success rate of type I CSP patients in this study was 94.1%, and that of type II CSP patients was 100%. There were no serious complications. There was a statistically significant difference in the amount of intraoperative bleeding between type II CSP patients and type I CSP patients (P=0.028), but there was no statistically significant difference in the length of hospital stay, operation time and hospital expenses (P>0.05).
Conclusion   Laparoscopic curettage for type I CSP patients is relatively safe with fewer complications; The success rate of laparoscopic curettage for patients with type II CSP is guaranteed to some extent, because the condition of previous scar lesions in the uterus can be judged again during the operation, and it is convenient for emergency treatment in the case of massive bleeding in the scar lesions of the uterus.