经阴道胚胎绞杀局部MTX注射联合宫腔镜下电切术治疗未破裂CSP7例分析

发布时间：2019-03-25 13:40

【摘要】：目的评估经阴道胚胎绞杀局部MTX注射联合宫腔镜下电切术治疗未破裂剖宫产子宫瘢痕妊娠(CSP)的疗效。方法回顾2013年10月至2014年12月浙江省绍兴市妇幼保健院7例未破裂CSP患者在超声介导下采用经阴道双腔取卵针直接绞杀灭活胚胎并MTX孕囊内注射,1周后行宫腔镜下胚胎电切术治疗,分析临床特点及治疗结局。结果孕龄47~96d,3个患者曾有2次剖宫产(42.86%)。治疗前β-hCG水平3 644~91086IU/L,MTX用量49~70mg,β-hCG降至正常时间(16.86±3.24)d。住院日平均(10±2.83)d。手术期间估计失血量50ml,不需要输血,无子宫破裂,无术后感染,白细胞减少症和肝功能损害。结论该方法能采用物理方法即刻灭活胚胎,MTX用量少,效果确切,是治疗未破裂CSP一种安全有效的保护妇女的生育能力的方法。
[Abstract]:Objective to evaluate the efficacy of transvaginal embryo strangulation with local MTX injection combined with hysteroscopic electroresection in the treatment of (CSP) during unruptured cesarean section. Methods from October 2013 to December 2014, 7 cases of unruptured CSP in Shaoxing Hospital of Zhejiang Province were treated with transvaginal double-chamber egg-taking needle and intravesical injection of MTX, using a double-chamber vaginal egg-taking needle to kill the embryo directly from October 2013 to December 2014 in Shaoxing City, Zhejiang Province. One week later, hysteroscopic electroresection of embryos was performed, and the clinical characteristics and outcome were analyzed. Results there were two cesarean sections (42.86%) in 3 patients with gestational age of 47 ~ 96 days. Before treatment, the level of 尾-hCG decreased to (16.86 卤3.24) d, and the dosage of 尾-hCG decreased to (16.86 卤3.24) d, and the dosage of 尾-MTX decreased to (16.86 卤3.24) d. The average day of hospitalization was (10 卤2.83) d. Blood loss during the operation was estimated to be 50 ml, no blood transfusion, no uterine rupture, no postoperative infection, leukopenia and liver function damage. Conclusion it is a safe and effective method for the treatment of unruptured CSP to protect the fertility of women. This method can inactivate embryos immediately by physical method, and the dosage of MTX is small and the effect is exact, it is a safe and effective method to treat unruptured CSP.
【作者单位】：浙江省绍兴市妇幼保健院;
【分类号】：R714.22

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