剖宫产术后子宫瘢痕妊娠临床诊治研究进展

发布时间：2018-03-31 17:35

本文选题：子宫瘢痕妊娠　切入点：剖宫产　出处：《南昌大学》2017年硕士论文

【摘要】：剖宫产术后子宫瘢痕妊娠(cesarean scar pregnancy,CSP)是一种罕见的异位妊娠,其发病率近年呈上升趋势,诊断和治疗技术也在不断发展和改进。诊断主要依靠经阴道超声、彩色多普勒三维成像等技术。CSP的早期诊断和选择合适的治疗方案对改善失血性休克、子宫切除等不良结局尤为重要。系统性使用甲氨蝶呤、刮宫术、子宫动脉栓塞、经腹或腹腔镜下妊娠病灶切除修补术和宫腔镜电切术是最常用的一线治疗方法。研究证明,子宫动脉栓塞术、经腹或腹腔镜下妊娠病灶切除修补术和宫腔镜电切术治疗风险低,成功率较高。系统性使用甲氨蝶呤、刮宫术治疗风险高,成功率较低。最近有报道使用Foley导管进行创新的微创治疗。治疗后再次怀孕是可行的,妊娠结局主要有正常宫内妊娠、流产、再发CSP、不孕以及胎盘植入,应被视为高危妊娠。
[Abstract]:Uterine scar pregnancy after cesarean section is a rare ectopic pregnancy. The incidence of Cesarean scar pregnancyn is increasing in recent years, and the diagnosis and treatment techniques are also developing and improving. The early diagnosis of CSP and the selection of appropriate treatment plan are particularly important to improve the adverse outcome of hemorrhagic shock, hysterectomy and other adverse outcomes, such as systemic use of methotrexate, uterine curettage, uterine artery embolism, and so on. Transabdominal or laparoscopic resection and repair of pregnancy foci and hysteroscopic resection are the most commonly used first-line treatments. Studies have shown that uterine artery embolization, transabdominal or laparoscopic resection and repair of pregnancy lesions and hysteroscopic resection are of low risk. The success rate is high. Systemic use of methotrexate, curettage treatment of high risk, low success rate. Recently reported use of Foley catheter for innovative minimally invasive treatment. Abortion, recurrent CSP, infertility, and placenta accreta should be considered high-risk pregnancy.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.22

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