目的：探讨宫、腹腔镜联合手术治疗剖宫产切口妊娠（CSP）的安全性、有效性及可行性。方法选择于2014年1月~2015年10月在我院住院的CSP患者50例分为3组，A组（20例）血HCG＜10000 mIU/ml，采用宫、腹腔镜手术治疗；B（15例）组血HCG＞10000 mIU/ml，先给予甲氨蝶呤肌注，待血HCG＜10000 mIU/ml时再手术；C组（15例）血HCG＞10000 mIU/ml，仍直接采用宫、腹腔镜手术。对术中出血量、手术时间、住院时间、手术成功率等进行统计学分析。结果三组患者均治愈出院，A、B组手术时间、出血量均明显低于C组，成功率高于C组，差异有统计学意义（P＜0.05）；B组住院时间明显高于C组，但手术时间、出血量均低于C组，差异有统计学意义（P＜0.05）。结论对血HCG较低病例，或血β-HCG较高患者先采用甲氨蝶呤肌注降低血HCG后，再行宫、腹腔镜手术治疗CSP，是安全、有效、可行的治疗方案，值得推广。%Objective To evaluate the safety,feasibility and effectiveness of Laparoscopic assisted hysteroscopy operation on CSP patients. Methods 50 CSP patients from january 2014 to october 2015 in our hospital were divided into three Groups.Group A(20 cases)who were HCG<10000mIU/ml,were treated with Laparoscopic assisted hysteroscopy operation.Group B (15 cases)who were HCG>10000mIU/ml,were treated by Methotrexate before Laparoscopic assisted hysteroscopy operation.Group C (15 cases) who were HCG>10000mIU/ml,were direct treated with Laparoscopic assisted hysteroscopy operation.Results Three groups prtients were hospital cures.Group A and B bleeding volume and opration time were less than Group C , the success rate were higher than Group C (P<0.05).The length of stay of Group B were longer than Group C,but bleeding volume and opration time were less than Group C (P<0.05).Conclusion It is safety,feasibility and effectiveness to use Laparoscopic assisted hysteroscopy operation on CSP patients,which HCG is in low level,or treated by Methotrexate of HCG who is in high level patients.This treatment is worth of popularizing.
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