剖宫产切口瘢痕妊娠患者采用宫腔镜及子宫动脉栓塞术联合治疗的效果及安全性分析

发布时间：2018-03-24 11:45

本文选题：瘢痕妊娠　切入点：剖宫产　出处：《中国内镜杂志》2016年09期

【摘要】：目的探讨剖宫产切口瘢痕妊娠患者(CSP)采用宫腔镜及子宫动脉栓塞术(UAE)联合治疗的效果及安全性分析。方法选取该院收治的36例CSP患者,入院时均给予宫腔镜及子宫动脉注入甲氨蝶呤(MTX),在β-人绒毛膜促性腺激素(β-HCG)降至1 000 u/L时,超声显示病灶与浆膜层厚≥0.2 cm时,在宫腔镜下将妊娠病灶切除。结果 UAE联合MTX动脉内注射的手术平均时间(20.12±3.85)min,治疗前后β-HCG水平以及病灶直径均明显降低,分别为[(17 902.74±11 818.23)u/L vs(12 842.73±8 525.73)u/L和(3.65±1.02)cm vs(3.12±0.97)cm],差异有统计学意义(t=8.58,P0.01和t=2.26,P0.05);宫腔镜手术平均时间(19.13±2.67)min,平均出血量(17.43±7.28)ml,术后30~45天逐步恢复正常规律月经,疗效满意。结论采用宫腔镜及UAE对CSP患者进行联合治疗,手术成功率高,术中出血量低,不良反应少,疗效满意。
[Abstract]:Objective to investigate the efficacy and safety of cesarean section incision for scar pregnancy (CSP) treated by hysteroscopy and uterine artery embolization. Methods 36 patients with CSP were treated in our hospital. On admission, both hysteroscopy and uterine artery were injected with MTX. When 尾 -HCG decreased to 1 000 u / L, ultrasound showed that the thickness of lesion and serous layer was more than 0.2 cm. Results the mean operative time of UAE combined with intraarterial injection of MTX was 20.12 卤3.85 min. The level of 尾 -HCG and the diameter of the lesion decreased significantly before and after treatment. The mean time of hysteroscopic operation was 19.13 卤2.67 min, the mean bleeding volume was 17.43 卤7.28 ml / min, and the normal menstruation was gradually restored at 3045 days after operation, and the difference was statistically significant (17 902.74 卤11 818.23)u/L vs(12 842.73 卤8 525.73)u/L and 3.65 卤1.02)cm vs(3.12 卤0.97)cm), respectively, and the mean time of hysteroscopy was 19.13 卤2.67 min, and the mean bleeding volume was 17.43 卤7.28 ml / min. Conclusion hysteroscopy and UAE are effective in the treatment of CSP patients with high success rate, low intraoperative bleeding, less adverse reactions and satisfactory curative effect.
【作者单位】：山东省菏泽市第三人民医院妇产科;
【分类号】：R713.8

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