宫腔镜在剖宫产瘢痕妊娠和宫颈妊娠治疗中的应用  

Application of hysteroscopic surgery in treatment of cesarean scar pregnancy and cervical pregnancy

作　　者：刘玉昆[1] 刘颖琳[1] 刘梅兰[1] 冯淑英[1] 张建平[1] 

机构地区：[1]中山大学孙逸仙纪念医院妇产科,广东广州510120

出　　处：《中国妇幼保健》2014年第1期146-149,共4页Maternal and Child Health Care of China

摘　　要：目的：探讨官腔镜在剖宫产瘢痕妊娠和宫颈妊娠治疗中的应用价值。方法：回顾性分析2005年1月-2011年12月该院应用宫腔镜治疗的瘢痕妊娠和宫颈妊娠患者的病例资料，对其临床表现、宫腔镜术前的处理、术前后HCG水平、术中情况、手术并发症、预后进行总结分析。结果：应用宫腔镜治疗剖宫产瘢痕妊娠9例，其中2例先行甲氨蝶呤（MTX）治疗，7例先行子宫动脉栓塞术（UAE）后再行宫腔镜手术。9例中2例因术中出血较多，中转开腹行病灶切除修补术。应用宫腔镜治疗宫颈妊娠6例，4例先行MTX治疗后再行宫腔镜，另外2例因HCG值已较低，直接行宫腔镜手术，手术均顺利完成。15例患者术后均恢复良好，无子宫切除者。结论：如病例选择适当，宫腔镜可安全、有效地应用于瘢痕妊娠和宫颈妊娠的治疗。Objective： To evaluate the value of hysteroscopic surgery in cesarean pregnancy and cervical pregnancy therapy. Methods： The clinical data of 15 patients with cesarean scar pregnancy or cervical pregnancy who were treated by hysteroseopie surgery in Sun Yat - sen Memorial Hospital from 2005 to 2011, including clinical presentation, preoperative treatment, HCG level pre and post procedure, complication of surgery and outcome of patients were analyzed retrospectively. Results： 9 patients with cesarean scar pregnancy underwent hysteroseopic sulgery. 2 of which were complicated bleeding during operation and followed by local resection and uterine repair by laparotomy. Preoperative UAE was applied in 7 patients and preoperative MTX medical treatment was applied in 2 patients. 6 patients with cervical pregnancy underwent hysteroscopic surgery uneventfully. Preoperative MTX medical treatment was applied in 4 patients. All patients had an unremarkable postoperative course. No patient underwent hysterectomy. Conclusion： Hysteroscopic surgery is a safe and effective treatment for cesarean scar pregnany and cervical pregnancy in appropriately selected patients.

关 键 词：剖宫产瘢痕妊娠 宫颈妊娠 宫腔镜 子宫动脉栓塞术 

分 类 号：R714[医药卫生—妇产科学]