剖宫产子宫瘢痕部位妊娠52例临床分析  

Clinical analysis on 15 cases with scar pregnancy after cesarean section

作　　者：侯玉兰[1] 郭端英[1] 范毅[1] 

机构地区：[1]广东省深圳市龙岗中心医院,518116

出　　处：《中国妇幼保健》2011年第4期508-510,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨剖宫产子宫瘢痕部位妊娠(CSP)的早期诊断方法及评估子宫动脉灌注栓塞术用于治疗CSP的临床疗效。方法:回顾性分析2004年1月～2009年12月收治的52例CSP病例的临床表现、超声检查及治疗效果。结果:45例经彩超检查提示瘢痕妊娠,33例行子宫动脉灌注栓塞术,6例因β-hCG水平较低采用MTX治疗,5例因瘢痕部位破裂行病灶切除及子宫修补术,5例因瘢痕部位包块较大行开腹手术治疗,3例经腹腔镜探查明确诊断及手术治疗。术后监测血β-hCG于2～5周均降至正常水平。结论:彩色多普勒超声检查可用于早期诊断CSP,子宫动脉灌注栓塞术具有微创、止血迅速、病灶萎缩快等优点,对于CSP是一种安全有效的治疗方法。Objective：To explore the method of early diagnosis of scar pregnancy after cesarean section,evaluate the clinical efficacy of uterine arterial perfusion and embolization in treatment of scar pregnancy after cesarean section.Methods：The clinical manifestations,ultrasonic examination and clinical efficacy of 52 cases with scar pregnancy after cesarean section who were treated in the hospital from January 2004 to December 2009 were analyzed retrospectively.Results：45 cases were diagnosed as scar pregnancy after cesarean section by color Doppler ultrasonography,33 cases received uterine arterial perfusion and embolization,6 cases were treated with MTX because of low level of β-hCG,5 cases received focal lesion excision and uterine repair because of rupture,5 cases received laparotomy because of scar large mass,3 cases were diagnosed definitely by laparoscopy,and operation was performed;after operation,serum β-hCG decreased to normal level.Conclusion：Color Doppler ultrasonography can be used for early diagnosis of scar pregnancy after cesarean section,uterine arterial perfusion and embolization has the advantages of minimal invasion,quickly to stop bleeding,fast atrophy of focal lesion,which is safe and effective in treatment of scar pregnancy after cesarean section.

关 键 词：剖宫产 瘢痕妊娠 彩色多普勒超声 子宫动脉栓塞术 

分 类 号：R719.8[医药卫生—妇产科学]