剖宫产瘢痕部位妊娠的诊断及治疗分析  

Clinical analysis of the diagnosis and united treatment of caesarean scar pregnancy

作　　者：张慧[1] 杨继[1] 李秀萍[1] 

机构地区：[1]西安市第四医院妇产科,陕西西安710004

出　　处：《中国妇幼健康研究》2011年第4期532-534,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨分析剖宫产瘢痕部位妊娠的诊断及治疗方法。方法回顾性分析西安市第四医院2005年12月-2010年12月对28例剖宫产瘢痕部位妊娠患者的诊断及治疗方案。结果①清宫组与化疗组及子宫动脉栓塞组3组间比较，术中出血量、血人绒毛膜促性腺激素转阴时间有显著性差异（F值分别为99．869、24．177，均P〈0．05），月经复潮时间无显著性差异（F=1．061，P〉0．05）；②子宫动脉栓塞组与化疗组比较，术中出血量、血人绒毛膜促性腺激素转阴时间存在显著性差异（t值分别为11．237、5．104，均P〈0．05），月经复潮时间无显著性差异（t=0．801，P〉0．05）；③化疗组中不同化疗方法的给药次数进行比较，全身化疗与局部化疗其氨甲喋呤给药次数存在显著性差异（t=2．287，P〈0．05）。结论①剖宫产瘢痕部位妊娠应早期联合治疗，化疗以及子宫动脉栓塞均为有效的治疗方法；②化疗时局部给药次数明显少于全身给药治疗。Objective To investigate the diagnosis and combined treatment of caesarean scar pregnancy （CSP）. Methods The diagnosis and treatment of 28 cases of CSP from December 2005 to December 2010 were retrospectively analyzed. Results There were significant differences in the intraoperative blood loss and the time of blood human chorionic gonadotropin （hCG） turning to be negative among direct abortion group, chemotherapy group and bilateral uterine artery embolization （UAE） treatment group （F was 99. 869 and 24. 177 respectively, P 〈 0.05）. There was no significant difference in the time of menstrual recover among three groups （ F = 1. 061, P 〉 0.05 ）. There were significant differences in the intraoperative blood loss and the time of hCG turning to be negative between chemotherapy group and UAE treatment group （t was 11. 237 and 5. 104 respectively, P 〈0.05）, but the difference in the time of menstrual recover between two groups was not significant （t = 0. 801, P 〉 0.05）. In the chemotherapy group, the time of administrating methotrexate （MTX） was significantly different between systemic chemotherapy group and local chemotherapy group （t = 2. 287, P 〈 0.05）. Conclusion CSP should be diagnosed early and treated with combined therapy. Chemotherapy and UAE treatment are the effective treatment methods. The time of drug administration in local chemotherapy is significantly fewer than that in systemic chemotherapy.

关 键 词：剖宫产瘢痕妊娠 超声 清宫术 栓塞 

分 类 号：R719.82[医药卫生—妇产科学]