Ⅱ型剖宫产瘢痕妊娠的腹腔镜处理  

Laparoscopic Surgery for Type Ⅱ Cesarean Scar Pregnancy

作　　者：戚燕妮[1] 吴丹梅[1] 杨帆[1] 张蕾[1] 盛庭立[1] 康楷[1] 

机构地区：[1]重庆市第九人民医院妇科,重庆400700

出　　处：《中国微创外科杂志》2015年第1期30-32,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨腹腔镜下子宫动脉阻断、病灶切除及子宫修补术治疗Ⅱ型剖宫产瘢痕妊娠（ cesarean scar pregnancy， CSP）的应用价值。方法回顾性分析2009年9月～2013年12月31例Ⅱ型CSP的临床资料，均在腹腔镜下游离出双侧子宫动脉并以3－0可吸收线结扎，然后行妊娠病灶切除及子宫修补术，5例有生育要求者松解子宫动脉的结扎线。术后随访血β－hCG、月经恢复的情况。结果31例手术均获成功，无中转开腹，无严重手术并发症。手术时间50～100 min，（70．4±12．3）min。术中出血量50～200 ml，（123．6±36．8）ml。术后血β－hCG降至正常时间10～25 d，（19．8±8．1）d，月经周期均恢复正常。结论腹腔镜下子宫动脉阻断、病灶切除及子宫修补术具备微创、安全、疗效确切等优点，是Ⅱ型CSP的有效治疗方法。Objective To investigate the safety and efficacy of laparoscopic uterine arteries ligation and ectopic gestational tissue excision in the treatment of typeⅡcesarean scar pregnancy （CSP）. Methods From September 2009 to December 2013, 31 cases of typeⅡCSP were treated by laparoscopy in our department.During the operation, the bilateral uterine arteries were separated and ligated with 3-0 absorbable threads under laparoscope and then the entire lesion was wedge resected.For 5 patients having further fertility requirement, the ligated absorbable threads were loosen.Clinical observations of postoperative β-hCG levels and menstrual cycles recovered were carried out. Results The procedure was successfully completed by laparoscopy without surgical complications or conversion to open surgery in all the cases.The operation time ranged 50-100 min, with a mean of 70.4 ±12.3 min, and the intraoperative blood loss was 50-200 ml, with a mean of 123.6 ±36.8 ml.Their postoperative β-hCG levels were decreased to a normal range in 10-25 days, with a mean of 19.8 ±8.1 days, and their menstrual cycles recovered as well. Conclusion With the advantages of minimal invasion and satisfactory effects, laparoscopic operation can be the best choice for the treatment of type Ⅱcesarean scar pregnancy.

关 键 词：Ⅱ型剖宫产瘢痕妊娠 腹腔镜 

分 类 号：R714.22[医药卫生—妇产科学]