HIFU联合清宫术在治疗子宫切口部位妊娠的应用价值
发布时间：2019-03-16 16:25
【摘要】：目的： 探讨HIFU联合清宫术用于治疗终止剖宫产后切口部位妊娠,了解治疗效果,并评价其临床应用价值。 方法： 收集2014年1月至2014年3月就诊于湖南省长沙市湘雅三医院13例子宫切口妊娠患者的病例治疗资料,13例患者在明确诊断为切口妊娠后行高强度聚焦超声(HIFU)治疗,HIFU术后3-4天行清宫术。从患者一般资料、HIFU术中灰度变化及超声造影结果、清宫术时手术时间、术中出血量、术后阴道流血时间、血β-HCG恢复并降至正常的时间、月经恢复时间以及住院时间和总费用等方面进行评价。 结果： 1.HIFU术中及术后情况 13例患者均成功完成高强度聚焦超声治疗。总治疗时间：46min-160min,总辐照时间300S-1538S；术中机载超声提示11例可见团块状灰度变化,13例整体灰度变化,CDFI:13例均未见明显血流灌注,对比术前、术后超声造影检查结果：孕囊及周边组织血流灌注明显减少。术后1-3天复查血β-HCG:11例患者血β-HCG均有不同程度下降,2例患者血β-HCG未见明显升高或下降。 2.清宫术后情况 13例患者于HIFU治疗后3-4天行清宫术,手术时间：15-56min,总出血量：15-500ml；术后阴道流血时间：1-13天；血β-HCG值恢复正常时间：10-35天；月经恢复正常时间：25-45天；术后随访1-3月,13例患者均未出现其他并发症。 3.住院时间及住院费用 13例患者总住院时间：5-10天；住院费用：15765.88-19305.16元,住院时间及住院费用明显少于采用子宫动脉介入栓塞术、开腹或腹腔镜手术治疗者。 结论： HIFU联合清宫术治疗子宫切口部位妊娠安全有效、风险小、费用少,值得临床推广应用。
[Abstract]:Objective: to evaluate the clinical value of HIFU combined with hysterectomy in the treatment of termination of pregnancy at the incision site after cesarean section. Methods: from January 2014 to March 2014, 13 cases of pregnant women with uterine incision in Xiangya third Hospital, Changsha City, Hunan Province, were collected. Thirteen patients were treated with high intensity focused ultrasound (HIFU) (HIFU) after definite diagnosis of incisional pregnancy, and 3 days after HIFU, uterine debridement was performed. From the general data of the patients, the results of contrast-enhanced ultrasound and gray-scale changes during HIFU, the time of operation, the amount of bleeding during the operation, the time of bleeding after operation, the time of blood 尾-HCG returning to normal, the time of recovery and reduction of 尾-HIFU to normal. Menstrual recovery time and hospital stay and total costs were evaluated. Results: high intensity focused ultrasound (HIFU) was successfully completed in 13 patients during and after 1.HIFU. The total treatment time was 46 min / 160 min and the total irradiation time was 300 S / 1538 S; The changes of mass gray scale were observed in 11 cases, global gray scale in 13 cases, and no obvious blood perfusion was found in CDFI:13 cases. The results of contrast-enhanced ultrasonography before and after operation showed that the blood perfusion of pregnancy sac and peripheral tissue decreased obviously. On the 3rd day after operation, 尾-HCG:11 decreased in all the patients, but there was no significant increase or decrease in 尾-HCG in 2 patients. 2. 13 patients underwent hysterectomy 3 days after HIFU treatment, the total bleeding volume was 15 脳 500 ml, the vaginal bleeding time was 1 day 13 days, the serum 尾-HCG value returned to normal time 10 days 35 days, the operation time was 15 minutes 56 minutes, the total bleeding volume was 15 渭 500 ml, the vaginal bleeding time was 1 day 13 days, the blood 尾-HCG value returned to normal time 10 days 35 days. After 1-3 months follow-up, there were no other complications in 13 patients. 3. The total hospitalization time and expenses of 13 patients were 5 to 10 days and 15765.88 yuan, 19305.16 yuan respectively. The length of hospital stay and the cost of hospitalization were significantly less than those treated by uterine artery interventional embolization, laparotomy or laparoscopy. The total length of hospital stay and total hospitalization cost were 5 days and 10 days, and 15765.88 yuan 19305.16 yuan respectively. Conclusion: HIFU combined with hysterectomy is safe and effective in the treatment of uterine incision pregnancy with low risk and low cost. It is worth popularizing and applying in clinical practice.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.8
本文编号：2441727
[Abstract]:Objective: to evaluate the clinical value of HIFU combined with hysterectomy in the treatment of termination of pregnancy at the incision site after cesarean section. Methods: from January 2014 to March 2014, 13 cases of pregnant women with uterine incision in Xiangya third Hospital, Changsha City, Hunan Province, were collected. Thirteen patients were treated with high intensity focused ultrasound (HIFU) (HIFU) after definite diagnosis of incisional pregnancy, and 3 days after HIFU, uterine debridement was performed. From the general data of the patients, the results of contrast-enhanced ultrasound and gray-scale changes during HIFU, the time of operation, the amount of bleeding during the operation, the time of bleeding after operation, the time of blood 尾-HCG returning to normal, the time of recovery and reduction of 尾-HIFU to normal. Menstrual recovery time and hospital stay and total costs were evaluated. Results: high intensity focused ultrasound (HIFU) was successfully completed in 13 patients during and after 1.HIFU. The total treatment time was 46 min / 160 min and the total irradiation time was 300 S / 1538 S; The changes of mass gray scale were observed in 11 cases, global gray scale in 13 cases, and no obvious blood perfusion was found in CDFI:13 cases. The results of contrast-enhanced ultrasonography before and after operation showed that the blood perfusion of pregnancy sac and peripheral tissue decreased obviously. On the 3rd day after operation, 尾-HCG:11 decreased in all the patients, but there was no significant increase or decrease in 尾-HCG in 2 patients. 2. 13 patients underwent hysterectomy 3 days after HIFU treatment, the total bleeding volume was 15 脳 500 ml, the vaginal bleeding time was 1 day 13 days, the serum 尾-HCG value returned to normal time 10 days 35 days, the operation time was 15 minutes 56 minutes, the total bleeding volume was 15 渭 500 ml, the vaginal bleeding time was 1 day 13 days, the blood 尾-HCG value returned to normal time 10 days 35 days. After 1-3 months follow-up, there were no other complications in 13 patients. 3. The total hospitalization time and expenses of 13 patients were 5 to 10 days and 15765.88 yuan, 19305.16 yuan respectively. The length of hospital stay and the cost of hospitalization were significantly less than those treated by uterine artery interventional embolization, laparotomy or laparoscopy. The total length of hospital stay and total hospitalization cost were 5 days and 10 days, and 15765.88 yuan 19305.16 yuan respectively. Conclusion: HIFU combined with hysterectomy is safe and effective in the treatment of uterine incision pregnancy with low risk and low cost. It is worth popularizing and applying in clinical practice.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.8
【参考文献】
相关期刊论文 前1条
1 严崴巍;;介入技术加清宫术治疗剖宫产子宫切口疤痕妊娠8例[J];中国医药导刊;2011年11期
，本文编号：2441727
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