经阴道剖宫产瘢痕妊娠病灶切除术9例报告

发布时间：2018-04-15 07:34

本文选题：剖宫产瘢痕妊娠 + 经阴道手术　；参考：《中国微创外科杂志》2015年02期

【摘要】：本文报道我院2013年1月~2014年3月经阴道行局部病灶切除术治疗外凸性剖宫产瘢痕妊娠9例。置阴道拉钩暴露,宫颈钳钳出宫颈前唇向外下方牵拉,暴露阴道前穹隆,宫颈阴道间隙内注入止血水(肾上腺素0.5 mg+生理盐水500 ml稀释),膀胱宫颈沟水平切开阴道黏膜,进入膀胱宫颈间隙,用手指向上及两侧分离并推开膀胱,暴露宫颈峡部病灶部位,剪开菲薄的肌层后吸取胚胎及部分坏死组织送病理,修剪切口周边瘢痕组织,宫腔内置引流管1枚,术后5 d取出。1号可吸收线行子宫肌层全层连续缝合(注意勿带内膜组织),阴道壁1号可吸收线行连续缝合。9例手术均获成功,平均手术时间65 min(40~90 min),平均出血量60 ml(40~80 ml)。平均住院时间7.5 d(5~10 d)。1例宫颈管粘连,余无并发症。术后月经恢复时间28~40 d。我们认为经阴道剖宫产瘢痕妊娠病灶切除术治疗剖宫产瘢痕妊娠,手术操作简单,值得临床推广应用。
[Abstract]:From January 2013 to March 2014, 9 cases of cicatricial pregnancy with convex cesarean section were treated with local resection of vagina.Vaginal retractor exposure, cervical forceps forceps out of the cervix anterior lip to pull down, expose the anterior vagina fornix, cervical vaginal space injection of hemostatic water (epinephrine 0.5 mg physiological saline 500ml dilution, bladder cervix trench horizontal vaginal mucosal incision,Enter the space of the bladder cervix, separate and push the bladder up and down with the fingers, expose the lesion of cervical isthmus, remove the embryo and some necrotic tissue from the thin muscle layer, and prune the scar tissue around the incision.One drainage tube was inserted into the uterine cavity, which was removed 5 days after operation. 1 absorbable line was used for the continuous suture of the myometrium of the uterus (attention should be paid not to the endometrial tissue), and the suture of the vagina wall 1 absorbable line was successful in all the 9 cases.The average operative time was 65 min(40~90 / min, and the average bleeding volume was 60 ml(40~80 / ml.The average hospitalization time was 7.5 days, 5 days and 10 days.The recovery time of menstruation was 28 ~ 40 days after operation.We consider that the surgical procedure for cesarean scar pregnancy is simple and worthy of clinical application.
【作者单位】：盘锦市中心医院妇二科;
【分类号】：R713.8

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