高强度超声聚焦联合宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效与安全性

发布时间：2018-01-29 23:30

本文关键词： 剖宫产术后子宫瘢痕妊娠高强度超声聚焦宫腔镜　出处：《中国医学计算机成像杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:探讨宫腔镜联合高强度超声聚焦(HIFU)终止剖宫产术后子宫瘢痕妊娠(CSP)的疗效和安全性。方法:回顾性分析2016年1月至2016年6月嘉兴市妇幼保健院收治的30例CSP病例资料,先行高强度超声聚焦治疗,治疗后2~3天再行宫腔镜手术,观察分析孕龄、术前血β-HCG水平、子宫峡部肌层厚度、病灶形态、手术成功率、治愈率、手术时间、术中出血量、术后阴道流血持续时间、血β-HCG恢复正常时间以及并发症等。结果:30例患者中位孕龄为45d(38~70d),术前中位血β-HCG为15000U/L(2694~161863U/L),子宫峡部肌层厚度平均为2.1mm(1.6~3.5mm)。30例中28例宫腔镜下见子宫峡部凹陷呈腔隙状,所有病例妊娠物均突向宫腔或峡部腔隙内,采用宫腔镜电切割环联合刮宫清除妊娠物。平均手术时间为(22±10)min,术中出血量(65±60)ml,手术成功率、治愈率均为100%(15/15),血β-HCG术后平均(23±10)d恢复正常,术后阴道流血持续时间平均(21±12)d消失。无一例并发症发生。结论:宫腔镜联合HIFU终止CSP安全、有效。
[Abstract]:Objective: to investigate the application of hysteroscopy combined with high intensity focused ultrasound (HIFU) in the termination of uterine scar pregnancy after cesarean section (CSP). Methods: the data of 30 cases of CSP admitted in Jiaxing Maternal and Child Health Hospital from January 2016 to June 2016 were retrospectively analyzed. Hysteroscopy was performed 2 days after the treatment. The gestational age, serum 尾 -HCG level, thickness of uterine isthmus muscle layer, shape of focus, success rate and cure rate were observed and analyzed. The operative time, the amount of intraoperative bleeding, the duration of postoperative vaginal bleeding, the recovery time of 尾 -HCG and complications were analyzed. Results the median gestational age of 30 patients was 45 days, 38 days or 70 days. Preoperative median serum 尾 -HCG was 15000U / L 2694U / L 161863 U / L). The thickness of myometrium of uterine isthmus was 2.1mm ~ (1.6) ~ 3.5mm ~ (-1) on average. 28 cases of uterine isthmus were found to be lacunar under hysteroscopy. All cases of pregnancy were protruding into uterine cavity or isthmus space. Hysteroscopic electrocution ring combined with curettage was used to remove pregnancy. The average operation time was 22 卤10 min, and the intraoperative bleeding was 65 卤60 ml. The cure rate was 100 / 15 / 15, and the blood 尾 -HCG recovered to normal on average 23 卤10 days after operation. The mean duration of vaginal bleeding was 21 卤12 days after operation. No complication occurred. Conclusion: hysteroscopy combined with HIFU is safe and effective in terminating CSP.
【作者单位】：嘉兴市妇幼保健院;
【分类号】：R445.1;R714.2
【正文快照】： 中国医学计算机成像杂志,2017,23:279-282Chin Comput Med Imag,2017,23:279-282Department of Gynaecology,Jiaxing Maternity and Child Health CareHospitalAddress:2468 Zhonghuandong Rd.,Jiaxing 314000,P.R.C.Co-address Correspondence to:ZHOU Li-xian(E-mail:103469

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