剖宫产切口瘢痕妊娠诊断和治疗方法的探究  

Study on diagnosis and treatment of cesarean scar pregnancy

作　　者：陈清仙[1] 赵涵[1] 聂津[1] 于素香[1] 解素勇 

机构地区：[1]唐县人民医院,河北唐县072350

出　　处：《医学研究与教育》2015年第1期67-69,共3页Medical Research and Education

摘　　要：目的探讨切口部位瘢痕妊娠的诊断与治疗。方法收集2012年3月至2014年9月于唐县人民院确诊的瘢痕妊娠(CSP)患者180例,按治疗方式不同分为2组,A组,直接行超声引导下清宫术150例;B组,肌注甲氨蝶呤(MTX)配合口服米非司酮后,行超声引导下清宫术30例,比较各组患者入院后的超声图像、血β-HCG值、治疗成功率、术中出血量、住院时间的差异。结果 180例患者中,有168例患者在治疗前明确诊断,12例患者在手术中或手术后出血时发现。临床治疗方法中,开腹手术治疗效果最佳,住院时间短,差异有统计学意义(P<0.05)。结论剖宫产CSP临床诊断主要采用彩色超声诊断,一旦明确后需要立即终止妊娠,对病情稳定的患者可以使用MTX配合米非司酮治疗后行刮宫术,对病情危重的患者可以使用开腹手术。Objective To study diagnosis and treatment of CSP（cesarean scar pregnancy, CSP）. Methods 180 cases diagnosed CSP were collected between March 2012 to September 2014 in our hospital, and the patients were divided into two groups according to different treatments. 150 cases in group A were conducted direct line of ultrasound-guided curettage. 30 cases in group B were conducted ultrasound-guided curettage followed methotrexate（MTX） and mifepristone treatment. Color ultrasound, β-HCG, success rate, bleeding and hospital stay time were compared between the two groups. Results 168 of 180 patients were diagnosed before treatment, and the other 12 patients were diagnosed by bleeding during or after surgery. Open surgery was the best clinical treatment method, and it had shorter hospital stay, the difference was statistically significant（P0.05）. Conclusion Color ultrasound is applied in clinical diagnosis of CSP mainly, once CSP is diagnosed, pregnancy requires immediate termination. Crtettage followed MTX and mifepristone are used for patients with stable conditions, while patients with serious illness can use open surgery.

关 键 词：剖宫产 瘢痕妊娠 甲氨蝶呤 刮宫术 

分 类 号：R714[医药卫生—妇产科学]