超声引导下行刮宫术治疗剖宫产术后瘢痕妊娠的意义和临床应用价值

发布时间：2018-03-04 08:33

本文选题：术后子宫瘢痕妊娠　切入点：刮宫术　出处：《东南大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的:探索剖宫产后子宫愈合情况和刮宫术出血量对瘢痕妊娠的影响,评估瘢痕形态是否适宜再妊娠。方法:选取2010年10月至2014年10月经承德医学院附属医院诊断的术后子宫瘢痕妊娠(CSP)患者61例,在超声引导下行刮宫术治疗,治疗后半年进行复查。根据患者刮宫术后2年内怀孕成功情况分为成功组(A组)与失败组(B组),对比分析两组患者刮宫术中出血量、尿β人绒毛膜促性腺激素(β-H CG)恢复阴性时间、复查时瘢痕处肌层增厚与否、血流是否异常以及卵泡刺激素(FSH)水平和黄体生成素(LH)水平是否异常。结果:刮宫术时出血量对CSP患者术后2年内怀孕具有一定的影响(P0.05),尿β-H CG恢复时间对CSP患者再妊娠成功与否影响不大(P0.05)。瘢痕肌层增厚及瘢痕处血流异常对CSP刮宫术后2年内怀孕影响较大(P0.05),FSH水平和LH水平异常对CSP刮宫术后2年内怀孕影响不大(P0.05)。结论:剖宫产时出血量大、瘢痕肌层增厚及瘢痕处血流异常对CSP患者再妊娠具有重要的影响,此类情况再妊娠时须密切关注妊娠情况。
[Abstract]:Objective: to explore the effect of uterine healing after cesarean section and the amount of bleeding in uterine curettage on scar pregnancy. Methods: from October 2010 to 2014, 61 patients with postoperative uterine scar pregnancy were treated with curettage under ultrasound guidance, which were diagnosed by the affiliated Hospital of Chengde Medical College from October 2010 to 2014. According to the successful pregnancy within 2 years after curettage, the patients were divided into two groups: successful group A (group A) and failure group group (group B). The blood loss during curettage was compared between the two groups. Urinary 尾 -human chorionic gonadotropin (尾 -H CGG) returned to negative time, and the thickness of muscle layer at scar was thickened or not at the time of reexamination. Results: blood loss during uterine curettage had a certain effect on pregnancy in CSP patients within 2 years after operation (P 0.05). The recovery time of urinary 尾 -H-CG had a certain effect on CSP patients. The effect of scar muscle layer thickening and blood flow abnormality on pregnancy in 2 years after CSP curettage is not significant. Conclusion: the effect of CSP curettage on pregnancy within 2 years after CSP curettage is not significant. The amount of blood lost during the birth of the palace is large. The thickening of scar muscular layer and the abnormal blood flow in scar have important influence on the re-pregnancy of CSP patients, and it is necessary to pay close attention to the condition of pregnancy.
【作者单位】：承德医学院附属医院超声科;承德市第三医院放射科;
【基金】：河北省科技支撑计划项目(20122177)
【分类号】：R445.1;R714.22

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