摘要
目的：探讨剖宫产术后子宫瘢痕妊娠的诊断及治疗方法。方法：对我院2004年1月～2008年12月收治的35例子宫瘢痕妊娠患者临床资料进行回顾性分析。结果：因前期对该病认识不足,7例患者治疗前2例误诊先兆流产,1例误诊为不全流产,4例误诊为宫内早孕,常规行人流术,术中均出现大出血,其中2例行子宫切除术;后期的28例患者均经超声检查明确诊断,术前予杀胚治疗,待HCG下降50%或降至1 000 IU/L以下,在B超引导下行清宫术治疗,其中20例手术顺利,出血不多;5例术中出血较多,经宫颈注射缩宫素及宫腔填塞纱布后血止;2例因大量阴道流血,保守治疗失败,且患者无再生育要求后行子宫全切术,1例因大出血,患者要求保留生育能力,转外院行介入治疗,保留了子宫。结论：超声是诊断子宫瘢痕妊娠的简便可靠方法。药物治疗、手术治疗及介入治疗是可选择的安全有效的治疗方法。
Objective：To investigate the diagnosis and treatment of cesarean scar pregna- ncy. Methods： 35 cases with CSP in our hospital from January of 2004 to January of 2008 were analyzed retrospectively. Resuits： Because of the deficiency of diagnosis experience about CSP, 2 cases of 7 cases were misdiagnosed as threatened abortion, 1 case was misdiagnosed as incomplete abortion, and 4 cases were misdiagnosed as early pregnancy. The 7 cases occurred serious colporrhagia during dilatation and curettage. Then 2 cases suffered from complete hysterectomy. 28 cases in later period were made a definite diagnosis by sonography. 28 cases were treated with Methotrexate before dilatation and curettage. When HCG decrease 50 % or to 1 000 IU/L, patients were treated with dilatation and curettage by sonography. The operation to 20 cases was successful and blood loss was not serious. 5 cases of bleeding were injected oxytocin; pitocin through cervix and tamponaded bandages in cavitary uten. 2 cases was treated with complete hysterectomy because of haemostasis failure for serious colporrhagia. 1 ease of serious colporrhagia was sent to other hospital and treated with interventional therapy successfully because of the request about potentia generandi. Conclusion： The sonography was a convenient and reliable diagnosistic method for CSP. Medicine or surgery was an effective and secure treatment for patients suffering from CSP.
出处
《内蒙古医学杂志》
2009年第5期570-572,共3页
Inner Mongolia Medical Journal
关键词
异位妊娠
剖宫产术
诊断
治疗
Eccyesis
Caesarean section
Diagnosis
Treatment
