Analysis Of The Effect Between Hysteroscopy And Ultrasound Monitoring Curettage On Cesarean Scar Pregnancy(Type ?)

Objective: To investigate different clinical effect between hysteroscopy and ultrasound monitoring curettage on uterine scar pregnancy(Type I)patients;to seek the best surgical method for uterine scar pregnancy(Type I).Methods: 78 patients with Cesarean scar pregnancy(CSP)(type I)treated in Huangshan People's Hospital from August 2012 to August 2019 were selected as subjects.All patients met the diagnostic criteria for type I pregnancy,and the gestational age was less than 8 weeks.The random number table method is divided into a control group(n=38cases)and an observation group(n=40 cases).The control group was treated with uterine curettage under ultrasound monitoring,and the observation group was treated with hysteroscopic CSP pregnancy removal.Including: duration of surgery,blood loss,operation time,hospitalization time,hospitalization cost,blood chorionic gonadotropin(HCG)reduced to normal time;using visual analog pain(VAS)scale for the two groups before and after operation 1,3,5,7d pain assessment;recording the success rate of the two groups of surgery;recording the proportion of blood HCG reduced to normal after 3weeks of the two groups,the proportion of common complications(perforation,infection,UAE,etc.);use flow The cytometer was used to measure the levels of T lymphocytes in two groups,including: CD3+,CD4+,CD8+,and CD4+/CD8+ levels;SPSS22.0 software was used to process all the data in this study.Results:(1)the intraoperative blood loss,duration of surgery,length of stay,and hospitalization cost in the observation group were shorter(less)under the ultrasound monitoring of the control group Hysterectomy(P<0.05);(2)VAS scores on 1,3,5,and7 days after surgery in both groups were lower than those before surgery(P<0.05);(3)35 patients underwent hysteroscopy surgery in the observation group,87.50%,this success rate,was higher than the control group's 55.26% for 21 cases(P<0.05);(4)There was no statistically significant difference in the percentage of blood HCG reduced to normal after 3 weeks of operation between the observation group and the control group(P>0.05);the number of postoperative perforation,infection,and UAE cases required in the observation group were lower than that of the control group(P <0.05);(5)The levels of CD3+,CD4+,CD4+/CD8+ were higher than prior treatment(P<0.05);CD8+ was lower than before treatment(P<0.05);7 days after operation,CD3+,CD4+,The level of CD4+/CD8+ was higher than that of the control group(P<0.05);CD8+was lower than that of the control group(P<0.05);Conclusions:Hysteroscopic CSP pregnancy material removal and ultrasound monitoring curettage can benefit patients in the treatment of CSP I,and?-HCG can reduce to the normal range after operation.But for the previous one,(1)duration of surgery is short;blood loss is small;the length of hospital stay can be shortened;the patient's economic burden can be reduced.(2)The former operation success rate is high,the patients had fewer postoperative complications and less pain response;(3)T lymphocytes in patients can restore to the balance state faster,and the safety is high.In general,hysteroscopic surgery has unique advantages in the application of uterine scar,and it is worth promoting;...