剖宫产术后疤痕处妊娠流产37例分析  

Analysis of abortion for pregnancy at uterine scar caused by previous cesarean section 37 cases

作　　者：白灵波[1] 任翰淼[1] 姚学莉[1] 冀栓猛[1] 张春柳[1] 王庆利[1] 

机构地区：[1]河北省邢台市人民医院,054031

出　　处：《中国妇幼保健》2014年第5期743-745,共3页Maternal and Child Health Care of China

基　　金：河北省科学技术厅计划内项目〔0627611055〕

摘　　要：目的:分析以不同方法终止剖宫产术后疤痕处妊娠的临床结局。方法:根据不同终止妊娠的方法,将剖宫产术后疤痕处妊娠37例分为3组:A组16例为直接人工流产组,B组7例为药物流产组,C组14例为血管介入明胶海绵栓塞子宫动脉后人工流产组。分析各组的流产成功率、出血量、子宫状况、生命体征及不良反应等临床结局。结果:A、B及C组的流产成功率分别为18.75%、57.14%及100.00%,差异有统计学意义(P<0.05);阴道大出血发生率分别为68.75%、28.57%及0,差异有统计学意义(P<0.05),均无死亡病例。结论:疤痕妊娠流产大出血病情凶险,先予明胶海绵栓塞子宫动脉栓塞再行人工流产安全、经济、微创、疗效确切,值得临床推广。Objective： To analyze clinical outcomes after cesarean section scar pregnancy by different methods to termination. Methods： Women with uterine scar caused by previous cesarean section 37 cases were analyzed retrospectively. They were divid- ed three groups according to methods of abortion： group A （artificial abortion directly 16 cases）, group B （medicine abortion 7 cases） and group C （vascular intervention gelatin sponge embolization of uterine artery before artificial abortion 14 cases） . Rate of abortion success, the amount of bleeding, uterine condition, vital signs and aside reactions were analyzed. Results： The rate of abortion success in group A, B and C were 18.75%, 57. 14% and 100% respectively. The difference was significant among three groups （P 〈0. 05） . The rate of heavy bleeding were 68. 75% , 28. 57% and 0 respectively. The difference was significant among three groups （P 〈 0. 05） . There was no deaths in every group. Conclusion： Because the abortion in heavy bleeding of uterine scar pregnancy is dangerous, the method of gelatin sponge embolization of uterine artery embolization is used at begining then to artificial abortion. This method is safe, economic, minimally invasive, effective and worthy to clinical wildlv effective and worthy to clinical wildly.

关 键 词：子宫动脉栓塞 流产 大出血 子宫疤痕处妊娠 

分 类 号：R737.33[医药卫生—肿瘤] R714.21[医药卫生—临床医学]