宫腔镜检查指导清宫术治疗剖宫产瘢痕妊娠22例分析  

The application of curettage under the guidance of hysteroscopy in the treatment of cesarean scar pregnancy:22 cases

作　　者：周明[1] 周燕莉[2] 郭蓉[1] 刘娓娓[1] 罗忆[1] 张雯娟[1] 

机构地区：[1]深圳市第五人民医院妇产科,广东深圳518001 [2]南方医科大学附属南方医院妇产科,广东广州510515

出　　处：《中国实用妇科与产科杂志》2011年第12期937-939,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨宫腔镜检查指导清宫术治疗剖宫产瘢痕妊娠的应用价值。方法对深圳市第五人民医院2008年1月至2011年5月收治的22例剖宫产术后子宫瘢痕妊娠患者进行宫腔镜检查指导清宫术,术中宫颈注射缩宫素及垂体后叶素,术毕给予甲氨蝶呤宫颈注射,术后复查血β-HCG及盆腔超声检查。结果 22例患者均1次手术成功,无中转开腹、子宫穿孔发生。手术时间平均(26.5±5.7)min,出血量平均(45.4±32.7)mL。术后3d血β-HCG下降平均83.6%±11.7%。术后血β-HCG8～25d降至正常。结论宫腔镜检查指导清宫术治疗剖宫产瘢痕妊娠具有创伤小,手术时间短,出血少,术后恢复快,住院时间短的特点,是安全、直接、准确、有效的治疗方法。Objective To evaluate the chnical effect of curettage under the guidance of hysteroscopy in the treatment of cesarean scar pregnancy. Methods Twenty-two patients with cesarean scar pregnancy were treated uterine curettage under the guidance of hysteroscopy and Oxytocin and Pituitrin were injected via cervix during the operation. After the operation, Methotrexate was given through cervical injection. Then the serum of β-HCG and pelvic uhrasound inspection were obtained after operation. Results All patients were successfully cured without the need of abdominal operation, and no uterine perforation, overhydration. Average operation duration was （26. 5 ± 5.7） min and the estimated blood loss during operation was （45.4 ± 32. 7）mL. Theβ-HCG level of day 3 postoperatively decreased by （83.6 ± 11.7 ）% and came to normal during 8 - 25 days after the operation. Conclusion Curettage under the guidance of hysteroscopy was safe and effective for cesarean scar pregnancy, with the advantage of minimal invasion, shorter duration of the operation, less blood loss and fast recovery.

关 键 词：子宫瘢痕妊娠 宫腔镜 清宫术 

分 类 号：R719.8[医药卫生—妇产科学]