Clinical efficacy of vaginal repair for type Ⅱ cesarean scar pregnancy / 局解手术学杂志

ABSTRACT

Objective To explore the clinical efficacy of vaginal hysterectomy and uterine scar repair in the treatment of type Ⅱ cesare-an scar pregnancy. Methods A total of 157 patients with type Ⅱ cesarean scar pregnancy (CSP) admitted to our obstetrics and gynecology department of our hospital from July 2016 to July 2017 were selected as research subjects. They were divided into ultrasound curettage group (n =87) and vaginal repair group(n =70) according to different surgical methods. The surgical bleeding volume, operative time, hospital stay and human chorionic gonadotropin (β-HCG) level before and after operation,the time of blood β-HCG returning to normal level,hemoglobin (HB) level before and after operation,menstrual recovery time,stress response, inflammatory response and surgical complications were compared between the two groups. Results The intraoperative blood loss volume, operative time and hospital slay in ultrasound curettage group were lower than those in vaginal repair group,the difference was significant(P ＜0.05). The time of blood β-HCG returning to normal level in vaginal repair group after operation was shorter than that in ultrasound curettage group, the difference was significant (P ＜ 0. 05). There was no significant difference in the HB level between the two groups(P＞0.05). The menstrual recovery time in vaginal repair group was shorter than that in ultrasound curettage group,the difference was significant(P ＜0. 05). The levels of postoperative epinephrine (E) and Cortisol (Cor) in vaginal repair group after operation were lower than those in ultrasound curettage group, while the level of thyroid stimulating hormone (TSH) was higher than that in ultrasound curettage group,the difference was significant(P ＜0.05). The levels of IL-2, IL-6 and IL-8 in vaginal repair group after operation were lower than those in ultrasound curettage group while the level of C-reactive protein (CRP) was higher than that in ultrasound curettage group,the difference was significant(P ＜0.05). The incidence rate of postoperative complications in ultrasound curettage group was higher than that in vaginal repair group(P ＜0. 05). Conclusion Vaginal repair is more beneficial to shortern the time of blood β-HCG returning to normal level and menstrual recovery time, promote the inflammatory factor and hormone recovery to a normal level, and reduce the incidence of complication.