宫腔观察吸引手术技术在剖宫产瘢痕妊娠治疗中应用的初探  

Preliminary study of application effect of intrauterine observation suction surgery technique in the treatment of caesarean scar pregnancy

作　　者：史亚楠[1] 王晓 高艳飞[1] 单淑芝[1] 江静[1] 石彬[1] Shi Yanan;Wang Xiao;Gao Yanfei;Shan Shuzhi;Jiang Jing;Shi Bin(Department of Obstetrics and Gynecology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院妇产科,石家庄050000

出　　处：《中华生殖与避孕杂志》2024年第1期73-76,共4页Chinese Journal of Reproduction and Contraception

摘　　要：目的了解宫腔观察吸引手术技术在剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)治疗中的应用效果及安全性。方法回顾性分析2019年4月至2022年6月期间于河北医科大学第二医院妇产科采用宫腔观察吸引手术技术作为初始治疗的7例CSP患者的临床资料。所有患者均使用一次性摄像吸引管同步观察吸引,术前3 h放置一次性宫颈扩张器,术后3 d复查血β-人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)及超声检查,必要时进行宫腔镜治疗。结果7例CSP患者中Ⅰ型3例,Ⅱ型4例,年龄为(33.9±4.7)岁,范围为27~40岁,停经时间范围为38~47 d,中位时间是43 d。所有患者手术过程均顺利,术中中位出血量30 mL,术后中位出血量20 mL,术后中位出血时间3 d,无子宫穿孔和术中大出血发生,术后所有患者血β-hCG均下降满意,6例复查超声未见明显异常,1例Ⅱ型患者因超声提示瘢痕部位强回声伴随丰富血流信号行宫腔镜电切术。结论宫腔观察吸引手术技术借助其内置于吸引管头端的高清摄像头,能真正做到观察与吸引同步,有望应用于停经≤47 d的Ⅰ型及部分Ⅱ型CSP的治疗。Objective To study application effect and safety of intrauterine observation suction surgery technique in the treatment of cesarean scar pregnancy(CSP).Methods A total of 7 patients with CSP who were treated with intrauterine observation suction surgery technique in Department of Obstetrics and Gynecology,the Second Hospital of Hebei Medical University from April 2019 to June 2022 were analyzed retrospectively.All patients used a disposable camera suction tube to observe the attraction synchronously.A disposable cervical dilator was placed 3 h before operation.Bloodβ-human chorionic gonadotropin(hCG)and ultrasound were reexamined 3 d after operation,and hysteroscopic treatment was supplemented if necessary.Results Seven patients included 3 cases of typeⅠCSP and 4 cases of typeⅡCSP,the age was(33.9±4.7)years ranging from 27 to 40 years,menopause ranged from 38 d to 47 d with median time of 43 d.The operation process of all patients was smooth,the median blood loss during operation was 30 mL,the median blood loss after operation was 20 mL,the median bleeding time after operation was 3 d,and there was no uterine perforation and massive bleeding during operation.Three days after operation,bloodβ-hCG decreased satisfactorily in all patients.Six cases showed no pregnant tissue residue,1 case underwent hysteroscopic resection due to strong echo with slightly rich blood flow signal at the scar site.Conclusion With the help of the high-definition camera built into the suction tube,the observation and suction can be synchronized with the suction technique,and can be applied to the treatment of type I and some typeⅡCSP with menopausal time no more than 47 d.

关 键 词：剖宫产瘢痕妊娠 宫腔观察吸引手术技术 一次性摄像吸引管 

分 类 号：R714.2[医药卫生—妇产科学]