摘要
目的探讨子宫剖宫产术后瘢痕妊娠的诊疗方法与效果。方法回顾性总结2010年6月至2013年6月本院收治的剖宫产术后瘢痕妊娠患者共51例:29例行甲氨蝶呤配伍米非司酮为主药物保守治疗;16例采用清宫术治疗,其中6例患者因孕囊周围血供丰富,清宫术前接受了双侧子宫动脉栓塞术治疗;6例采用其他手术方式治疗,如局部病灶切除加子宫修补术、宫腔镜下电切去除妊娠物等。比较药物保守治疗组与清宫术组患者再次就诊率、住院天数以及血β-h CG下降至正常水平所需要的时间等指标;以及清宫术组中栓塞患者与未栓塞患者的失血量。结果清宫术组再次就诊率、以及β-h CG下降至正常水平所需要的时间等指标均优于药物保守治疗组(P<0.05),差异有统计学意义。清宫术组中未栓塞患者的失血量波动较大。结论子宫剖宫产瘢痕部位妊娠中采用清宫术治疗安全有效,优于单纯的药物保守治疗,有临床推广价值,但需注意其适应症。
Objective To explore the therapeutic methods and effects on cesarean scar pregnancies（ CSP）. Methods A total of 51 patients with cesarean scar pregnancies were received from the department of gynaecology in Guangzhou Women and Children＇s Medical Center during June 2010 through June 2013. Among these,29 patients underwent medicine conservative treatment including methotrexate and mifepristone; 16 patients underwent curettage and 6 of them was treated with uterine arterial embolizatio（ UAE） because of the abundant blood flow signals according to Ultrasonic Doppler; 6 patients underwent other surgical treatment such as wedge resection of CSP and hysteroscopic resection. And compared the recurrence rate of hospitalization,days of hospitalization and days of β-HCG becoming normal between patients with medicine conservative treatment and curettage as well as the blood loss between patients with and without UAE in the group of curettage. Results Curettage was better than medicine conservative treatment according to the recurrence rate of hospitalization and days of β-HCG becoming normal（ P〈0. 05）. And the blood loss in the patients without UAE was not stable.Conclusions Curettage is a safe and effective therapeutic method for CSP which is better than medicine conservative treatment. And it should be popularized in clinical practice.
出处
《齐齐哈尔医学院学报》
2015年第19期2833-2835,共3页
Journal of Qiqihar Medical University
关键词
剖宫产
瘢痕妊娠
清宫术
Caesarean
Cesarean scar pregnancies
Curettage
