| Objective: Through statistical analysis of the different treatment methods taken by pregnant patients with cesarean section scars,and then understand the effectiveness,advantages and disadvantages of different treatment methods,in order to provide correct guidance for the selection of reasonable clinical treatments for CSP patients.Methods: From January 2018 to October 2020,the electronic and paper medical records and follow-up information of 132 patients who were admitted to the Xiangxi Autonomous Prefecture People’s Hospital at the cesarean section scar site were collected for retrospective analysis.The case data reviewed include: general information: age,blood β-HCG value before treatment,menopausal time,time from previous cesarean section,parity,number of uterine cavity operations,maximum diameter of gestational sac,whether there is a fetal heart in the gestational sac Etc.;CSP classification of patients,treatment options selected;follow-up after discharge: time when blood β-HCG value drops to negative,time for menstrual renewal,whether there is a second operation,etc.The different treatments of CSP patients were divided into groups,including hysteroscopy combined with pituitrin(group A)in 71 cases,methotrexate combined with uterine evacuation(group B)in 61 cases,using the relevant data of two different treatment methods SPSS 24.0 performs statistical analysis to further evaluate the success rate and effect of different treatment methods for CSP patients.Results: There were 71 cases in group A,61 cases in group B,of which 58 were CSP type I cases in group A,13 were CSP type II cases,42 were CSP type I cases in group B,and 19 were CSP type II cases.χ2=2,944,P=0.086>0.05,the difference was not statistically significant.The treatment success rate of group A was 98.6%,and the treatment success rate of group B was 100%.General situation: 71 cases in group A,the age distribution of patients is 23-43 years old,the average age is(31.96±4.833)years,the menopausal days are 37-84 days,the average is(49.79±8.718)days,the number of cesarean section is 1～3 The average number of times was(1.75±0.579)times,the number of uterine cavity operations was 1-8times,and the average was(3.73 ± 1.444)times.The interval from the previous cesarean section was 10 to 182 months,with an average of(51.99±36.339)months.There were 61 cases in group B,42 cases in type Ⅰgroup and 19 cases in type Ⅱ group.The ages of patients in group B ranged from 24 to 41 years,the average age was(31.84±4.306)years,the menopausal days were 36 to 76 days,the average was(51.02±9.474)days,the number of cesarean sections was 1 to 3,and the average was(1.77±0.589).)Times,the history of uterine cavity operation was 1 to 7 times,with an average of(3.79±1.550)times,and the interval from the previous cesarean section was 5 to 128 months,with an average of(57.36±32.997)months.Age between groups A and B(P=0.880>0.05),menopausal time(P=0.453>0.05),number of cesarean sections(P=0.813>0.05),number of uterine cavity operations(P=0.835>0.05)),compared with the time between the previous cesarean section(P=0.378>0.05),the difference was not statistically significant(P>0.05).There was no significant difference in the blood β-HCG value before treatment(P=0.970>0.05)and the largest diameter of the pregnancy lesion(P=0.508>0.05)between the two groups(P>0.05).Among the 71 cases in group A,11 cases showed heart tube beats on ultrasound,accounting for 15.49% of group A.Of the 61 cases in group B,13 cases showed heart tube beats on ultrasound,accounting for21.31% of group B.Group A,B Χ2=0.747,P=0.388>0.05 between the two groups,the difference was not statistically significant.There were statistically significant differences in intraoperative blood loss and operation time between group A and group B(P<0.05).The operation time of hysteroscopy combined with pituitary gland is longer than that of methotrexate combined with uterine evacuation.However,from the perspective of intraoperative blood loss,the surgical method of hysteroscope combined with pituitary gland is intraoperative The amount of bleeding is less than that of methotrexate combined with uterine evacuation.There were statistically significant differences in hospitalization expenses,hospitalization time,time for HCG to fall to negative(<5m IU/ml),and menstrual renewal time between group A and group B(P<0.05).In CSP type I patients,the hospitalization cost of hysteroscopy combined with pituitrin is less than that of methotrexate combined with uterine evacuation,and the length of hospital stay,the time for HCG to fall to negative,and the time for menstrual renewal are all shorter than those of a nail There was a statistically significant difference in patients with methotrexate combined with uterine evacuation(P <0.05).In CSP II patients,the hospitalization cost of hysteroscopy combined with pituitrin is less than that of methotrexate combined with uterine evacuation,and the length of hospitalization,the time for HCG to fall to negative,and the time for menstrual renewal are all shorter than those of a nail There was a statistically significant difference in patients with methotrexate combined with uterine evacuation(P <0.05).Conclusion:1.Hysteroscopy combined with pituitrin has a high success rate in the treatment of CSP type I,and has the advantages of short hospital stay,quick recovery,and low cost.It is the recommended method of choice.2.Methotrexate(MTX)combined uterine evacuation is suitable for CSP type I.It is relatively simple to operate and does not require high equipment.It is suitable for some primary hospitals.3.For Type II and Type III CSP,the treatment plan should be carefully selected after assessing the risk of bleeding. |
PDF Full Text Request