摘要
目的探讨诊断和治疗特殊类型剖宫产术后子宫疤痕妊娠(CSP)的有效方法。方法回顾性分析同济医院2000年1月～2008年12月9年间所有植入疤痕缺陷处向膀胱和腹腔内生长的CSP的病例共58例,其中42例接受了双侧髂内动脉结扎+局部病灶切除+子宫修补术,16例术前接受了双侧髂内动脉栓塞术并于术后5～7d内行局部病灶切除+子宫修补术。结果接受双侧髂内动脉结扎+局部病灶切除+子宫修补术治疗的患者在术中平均出血量和术后大多数并发症方面与先行双侧髂内动脉栓塞术后于5～7d内行局部病灶切除+子宫修补术的患者相比均无显著性差异,但其住院费用及护理费用远远低于后者,且其在平均住院日上亦有显著优势。结论经阴道彩超或三维超声检查是诊断剖宫产术后子宫疤痕妊娠的可靠手段。在治疗CSP导致的大出血时可考虑行髂内动脉栓塞术,待病情稳定或辅助药物治疗后行局部病灶切除+子宫修补术或清宫术,而治疗植入疤痕缺陷处向膀胱和腹腔内生长的CSP时髂内动脉结扎+局部病灶切除+子宫修补术显然在安全性及经济学方面均有显著优势。
Objective To investigate the optimal methods for diagnosing and treating cesarean scar pregnancy （CSP）. Methods Fifty-eight cases of special type CSP which were treated in our hospital from 2000 to 2008 were analyzed retrospectively. Methods Fifty-eight cases of special type CSP which were treated in our hospital from 2000 to 2008 were analyzed retro- spectively. Results There was no significant difference in average intraoperative blood loss and postoperative complications between the patients who accepted bilateral hypogastric artery ligation and those treated with bilateral hypogastric artery embolization. But the hospital charges and the nursing care costs were all much cheaper in the former, and hospital stay was shorter. Conclusion Transvaginal color Doppler ultrasound or three-dimensional ultrasound examination is reliable diagnostic means of CSP. Internal lilac artery ligation ＋ partial lesion resection ＋ uterine neoplasty have significant advantages in safety and economics in the surgical treatment of special type CSP.
出处
《华中医学杂志》
CAS
2009年第5期245-247,共3页
Central China Medical Journal
关键词
异位妊娠
剖宫产术后切口
妊娠
手术治疗
Ectopic pregnancy
Cesarean scar
Pregnancy
Surgical treatment
