The Clinicai Effect Of Two Surgicai Methods In The Treatment Of Type Ii Uterine Scar Pregnancy

Objective:In this paper,I will compare the clinical effect of two kinds of surgical methods: trans-vaginal cesarean scar pregnancy debridement surgery and uterine artery embolization combined with B-ultrasound guided curettage in the treatment of type Ⅱ CSP.Methods:50 patients with type Ⅱ CSP treated in the first affiliated hospital of hebei north college from January 2016 to December 2017 were retrospectively analyzed.According to the different methods of operation method,it can be divided into two groups,group A were treated by trans-vaginal cesarean scar pregnancy debridement surgery and group B were treated by uterine artery embolization combined with B-ultrasound guided curettage.Analysis indicators: The postoperative hospital days,operation time,intraoperative blood loss,treatment cost,the time of postoperative serump β-HCG recovery normal and complications were compared between the two groups.Statistical analysis: all the data were analyzed by SPSS17.0.Measurement data were normally distributed test and homogeneity of variance test,if the data meet the normal distribution and homogeneityof variance,the independent sample t text,each set of data is represented by(x±s);Normality is not satisfied with the median represented using Mann-Whitney U test;Enumeration data were compared with χ2 test or Fisher test.a = 0.05(bilateral)as the test level,P < 0.05 was considered statistically significant.Results:1.The comparison of the basic data of the two groups of patients:There was no significant difference in age,pregnancies,delivery,cesarean section,menopause days,thickness of the muscle scar,and the initial serump β-HCG value(P > 0.05);2.The comparison of postoperative hospital days between two groups: The postoperative hospitalization time of the patients in group A was 2(2~3)days after operation,and in group B was 2(2~4)days after operation.There was no significant difference between the two groups(P = 0.37);3.The comparison of operation time between two groups: the operation time of group A was 40(35~46)min,the operation time of group B was 16(14~50)min.The operative time of group A was longer than that of group B,and the difference was statistically significant(P <0.01);4.The comparison of intraoperative blood loss between two groups: The intraoperative blood loss in group A was 60(40~70)m L,and the intraoperative blood loss in group B was 50(40~500)m L.There was no significant difference between the two groups(P = 0.17);5.The comparison of the treatment cost between the two groups:The treatment cost of group A was(7971.61±76.00)yuan,and in group B was(14663.31±179.15)yuan.The results showed that the cost of treatment in group A was less than that in group B,There is significant statistical significance in comparison(P < 0.01);6.The comparison of the the time of postoperative serumpβ-HCG recovery normal between the two groups: the recovery time of serum β-HCG to normal in group A was(23.67±2.76)d after operation,and in group B was(24.28±2.84)d.There was no significant difference between the two groups(P = 0.45);7.The comparison of intraoperative and postoperative complications between the two groups: The incidence of complications in group A was 0%.The incidence of complications in group B was 34.5%.The data of two groups were counted by fisher test,and the difference has statistically significant(P < 0.05).Conclusion:For the treatment of type Ⅱ CSP,trans-vaginal cesarean scar pregnancy debridement surgery has the advantages of low cost,high safety,quick recovery and less complications,etc.It is worth promoting in clinical.