The Clinical Value Of Laparoscopic Uterine Artery Occlusion Combined With Focal Resection For Cesarean Scar Pregnancy Therapy

Objective:To explore the clinical value of laparoscopic uterine artery block combined with focal resection for cesarean scar pregnancy therapy.Methods:Retrospective analysis of 80 cases of cesarean scar pregnancy patients treated in our hospital from August 2017 to August 2019.The age range of the patients was 23 to 49 years,and the average age was 32.98 ± 4.56 years,including bilateral uterus Arterial embolization combined with hysterectomy was performed in 38 patients in group A,and laparoscopic uterine artery block combined with focal resection was performed in 42 patients in group B.Analysis of medical records include age,gestational age,number of previous cesarean sections,the time interval between the last pregnancy and cesarean scar pregnancy,and clinical indicators and prognosis.Results:The results of this study show that the operation time of laparoscopic descending branch of uterine artery combined with uterine surgery is significantly shorter than that of bilateral uterine artery embolization combined with uterine surgery(P<0.05).Compared with laparoscopic uterine artery occlusion and hysterectomy under bilateral uterine artery embolization combined with hysterectomy,the intraoperative blood loss was significantly increased,and the difference was statistically significant(P<0.05).The success rate of bilateral uterine arterial embolization combined with hysterectomy was 97.37%,and the success rate of laparoscopic descending branch uterine artery block combined with hysterectomy was 95%.Comparing the surgical success rates of the two groups,the results showed no significant difference.(P>0.05).However,the duration of vaginal bleeding,the time of serum β-HCG return to normal,and the period of menstrual recovery were significantly shorter than those of bilateral uterine arterial embolization combined with hysterectomy,and there were significant statistics.The difference was significant(P<0.05).Complications that occurred after surgical treatment included postoperative fever,post-embolism syndrome,postoperative pain,adjacent organ damage during surgery,postoperative bleeding,and cervical canal adhesions.Postoperative complications occurred in the two groups of patients.The rates were not significantly different(P>0.05).The length of hospital stay of patients undergoing laparoscopic uterine artery occlusion and hysterectomy was significantly shorter than that of patients in group A with bilateral uterine arterial embolization combined with hysterectomy(P<0.05).In the group,bilateral uterine arterial embolization combined with hysterectomy was statistically significant(P<0.05)Conclusion:Laparoscopic uterine artery descending branch block combined with hysterectomy has a short operation time,low intraoperative blood loss,fast recovery,short hospital stay,low cost,fertility preservation,postoperative vaginal bleeding duration,and serum β-HCG return to normal time And menstrual recovery time is short.Postoperative complications were fewer.The results show that laparoscopic uterine artery occlusion combined with focal resection has better therapeutic effect and clinical value for cesarean scar pregnancy.It summarizes and expands the application of laparoscopic uterine artery occlusion combined with focal resection.It also further optimizes the treatment plan for cesarean scar pregnancy,improves the prognosis of patients,and reduces the pain and economic pressure of patients.