宫腔镜在内生型剖宫产术后切口瘢痕妊娠治疗中的临床分析  

Clinical Analysis of Hysteroscopy in the Diagnosis and Treatment of En-dogenous Cesarean Scar Pregnancy

作　　者：关峰[1] 付强[1] 高天明[1] 

机构地区：[1]大连大学附属中山医院妇产科,辽宁大连116000

出　　处：《医学与哲学（B）》2015年第2期29-31,44,共4页Medicine & Philosophy(B)

摘　　要：为了探讨宫腔镜在剖宫产术后切口瘢痕妊娠(CSP)治疗中的临床应用价值及治疗后体会,回顾性分析内生型剖宫产术后切口瘢痕妊娠患者39例,术前均应用米非司酮或加用甲氨蝶呤降低血β-HCG水平,之后在B超监测下采用宫腔镜下清宫术或病灶电切术为研究组,采用传统的负压吸宫术为对照组。对患者停经时间、术前血β-HCG值、术中出血量、手术时间、住院时间,术后血β-HCG下降正常所需时间以及月经恢复时间进行对比分析。结果所有患者手术均顺利完成,术后随访3个月,对照组术中平均出血量,血β-HCG降至正常的时间及月经恢复时间均明显高于研究组,其差异有统计学意义(P<0.05)。因此在米非司酮或加用甲氨蝶呤预处理的基础上,联合B超监测,宫腔镜作为一种微创技术治疗内生型CSP患者是安全、有效的,具有非常重要的临床开展价值。To investigate the clinical application value and experience of hysteroscopy treating cesarean scar pregnancy （CSP）. Retrospectively analyzed the data of 39 en-dogenous patients with CSP. All patients were given mifepristone or plus methotrexate （MTX） to reduce β-HCG before operation, then in B-ultrasound monitoring, observation group were given hysteroscopic curettage and lesion resection, control group were taken curettage. Compared and analyzed the menstruation stop time, preoperative blood β-HCG level, intraoperative blood loss, time of operation, time of discharging from hospital, postoperative blood β-HCG dropped to normal time and postoperative menstruation recovery time between the two groups. All the en-dogenous CSP patients were successfully eompleted surgery. Patients were followed-up for 3 months, intraoperative blood loss, postoperative blood β-HCG dropped to normal time, and postoperative menstruation recovery time in control group were statistically significantly higher than those in observation group, there were statistically significant differences in the two groups （P〈0.05）. So after drug （mifepristone or plus MTX） pretreatment. Hysteroscopic surgery as a minimally invasive surgery assisted by B-ultrasound during operation is regarded as the safe and effective management to en-dogenous cesarean scar pregnancy, is very important to carry out value in diagnosis and conservative treatment of CSP.

关 键 词：剖宫产 剖宫产术后切口瘢痕妊娠 宫腔镜 

分 类 号：R714.2[医药卫生—妇产科学]