剖宫产瘢痕妊娠的治疗进展  

Treatment progress of caesarean scar pregnancy

作　　者：刘欣燕[1] 吴琳琳[1] 

机构地区：[1]中国医学科学院.北京协和医学院.北京协和医院妇产科,北京100021

出　　处：《中国计划生育和妇产科》2013年第4期8-11,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：剖宫产瘢痕妊娠(caesarean scar pregnancy,CSP)的治疗原则就是及时终止妊娠、尽可能保留患者生育功能和杜绝严重并发症,但是目前尚无规范化的治疗方案。患者的症状体征、孕周大小、超声表现、血β-人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)指标、是否有生育要求及诊疗技术等是选择治疗方案的重要参考指标。治疗方式有药物治疗和手术治疗。治疗药物包括甲氨蝶呤和米非司酮等,疗效比较可靠。手术治疗包括清宫术、宫腔镜手术、腹腔镜手术、开腹病灶切除术、开腹全子宫切除术等,治疗效果可靠。双侧子宫动脉栓塞技术在CSP治疗中非常重要,不仅可以迅速有效地抢救术中大出血,而且也是安全的术前预防出血的方法。The treatment principles of caesarean scar pregnancy （CSP） are terminating pregnancy timely, preserving fertility function and preventing severe complications as much as possible, but currently, there is no standardized protocol for the treatment of CSP. Symptoms and signs, gestational age, uhrasonographic findings, level of serum ~3 - human chorionic gonadotrophin（HCG） and fertility desire are important reference index of the treatment option. Primary treatments include drug therapy and surgery. Drug, such as Methotrexate （MTX） and Mifepristone （RU486）, the curative effect is relatively reliable. Surgery, including dilatation and curettage （D＆C）, hysteroseopy, laparoscopie surgery and laparotomy procedure for resection of lesions, hysterectomy etc. of which the therapeutic effect is very reliable. Bilateral uterine artery embolization is crucial for CSP. It is not only an effectivehemostasis, but also an effective precaution of hemorrhage.

关 键 词：剖宫产 瘢痕妊娠 治疗进展 

分 类 号：R714.2[医药卫生—妇产科学]