剖宫产切口瘢痕妊娠分析  

Analysis of Cesarean Scar Pregnancy

作　　者：叶青剑[1] 邓佩霞 沈晓婷[3] 成娟[1] 

机构地区：[1]中山大学附属第三医院妇科,广东广州510630 [2]邵阳市中心医院妇产科,湖南邵阳422000 [3]中山大学附属第一医院生殖科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2017年第4期596-600,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金项目(S2013040014613)

摘　　要：【目的】回顾性分析剖宫产瘢痕部位妊娠(CSP),3种不同治疗方案的疗效及其优缺点。【方法】2006年5月至2016年9月期间中山大学附属第三医院及中山大学附属第一医院妇科确诊并治疗的CSP 186病例,根据其治疗方案,分为3组:手术组(经阴道剖宫产瘢痕部位妊娠物切除+修补术,73例)、药物组(MTX+米非司酮+清宫术,51例)、栓塞组(双侧子宫动脉栓塞后+清宫术,62例)。比较3组治疗方案的成功率、住院时间、住院费用及治疗副作用。【结果】3组治疗方案中成功率分别为:98.6%、54.9%、80.6%;住院时间为(7.3±3.3)、(16.2±11.2)、(12.6±10.4)d;住院费用为(7 966±1 987)、(5 499±1 965)及(15 863±5 941)元;治疗副作用发生率为:15.1%、23.5%、37.1%;以上比较均有统计学差异(P<0.05)。其中手术组成功率最高,住院时间最短,费用较低,治疗副作用也最少,并且无严重的并发症出现。【结论】经阴道剖宫产瘢痕部位妊娠物切除+修补术是治疗子宫部位瘢痕妊娠安全,有效的方法。[Objective ] To explore the clinical effects of three methods in the treatment of cesarean scar pregnancy. [ Method ] All the patients with cesarean scar pregnancy accepted treatment at 2 affiliated hospitals of Sun Yat-Sen University from May 2006 to September 2016 were retrospectively analyzed. According to their different therapies, 186 of them were divided into three groups ： surgery group （undergone transvaginal removal of eetopic pregnancy tissue and repair of uterine defect, 73 cases）, medical treatment group （treated with medical and combined with curettage, 51 cases ） , UAE group （treated with UAE and combined with suction curettage, 62 cases）. The success rate, hospitalization time, hospitalization expenses and treatment side effects of the three groups were compared. [ Result ] The success rates of the three groups were 98.6%, 54.9%, and 80.6% ;The hospitalization days of the three groups were （7.3 ± 3.3） days, （16.2 ±11.2） days, （12.6 ± 10.4） d. The hospitalization expenses of the three groups were （7 967± 1 987） yuan, （5 499±1 965） yuan, （15 863 ± 5 941） yuan. The treatment side effects of the three groups were 15.1%, 23.5%, and 37.1%. The success rate, hospitalization days, hospitalization expenses and treatment side effects of the three groups were statistically different （P 〈 0.05 ）. The surgery group has a highest success rate, shortest hospitalization time, lower hospitalization expenses, and less complication. [ Conclusions ] Transvaginal removal of eetopic pregnancy tissue and repair of uterine defect is a reliable treatment for CSP.

关 键 词：剖宫产瘢痕部位妊娠 子宫动脉栓塞 经阴道手术 

分 类 号：R714.22[医药卫生—妇产科学]