Abstract
Objective:To explore the effect of vaginal lesion resection combined with uterine wall repair in the treatment of cesarean scar pregnancy(CSP).Method:A total of 86 pregnant patients with CSP treated in Xintai People's Hospital from January 2019 to January 2022 were selected as the study objects,and they were divided into control group(uterine embolization+uterine cleaning surgery)and observation group(vaginal lesion resection combined with uterine wall repair)by random number table method,with 43 cases in each group.The clinical indexes[surgery time,postoperative vaginal bleeding time,postoperative β-human chorionic gonadotropin(β-hCG)recovery time,hospitalization time],ovarian reserve function indexes[follicular estrogen(FSH),luteinizing hormone(LH),estradiol(E2),β-hCG]and stress indexes[adrenocorticotropic hormone(ACTH),aldosterone(ALD),cortisol(Cor)],uterine hemodynamics indexes[end-diastolic blood flow velocity(EDV),resistance index(RI),peak systolic blood flow velocity(PSV),pulsation index(PI)]and complication rate between the two groups were compared.Result:The surgery time of the observation group was longer than that of the control group,and the postoperative vaginal bleeding time,postoperative β-hCG recovery time and hospitalization time were shorter than those of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in ovarian reserve function indexes,stress indexes and uterine hemodynamics indexes between the two groups(P>0.05).At 7 d after surgery,FSH and LH in two groups were higher than those before surgery,E2 and β-hCG were lower than those before surgery,but FSH,LH and β-hCG in observation group were lower than those in control group,E2 were higher than that in control group,the differences were statistically significant(P<0.05).At 7 d after surgery,ACTH,ALD and Cor in two groups were higher than those before surgery,but which in observation group were lower than those in control group,the differences were statistically significant(P<0.05).At 3 d after surgery,EDV,RI,PSV and PI in two groups were lower than those before surgery,and which in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:In the treatment of pregnant patients with CSP,the treatment of vaginal lesion resection combined with uterine wall repair has remarkable effect,less surgical stress reaction,little influence on ovarian reserve function,regulation of uterine hemodynamics,and reduction of complications.关键词
阴式病灶切除术/子宫壁修补术/剖宫产/子宫瘢痕妊娠Key words
Vaginal lesion resection/Uterine wall repair/Caesarean section/Uterine scar pregnancy
