不同方案治疗剖宫产术后子宫瘢痕妊娠28例临床分析

发布时间：2019-05-20 13:11

【摘要】：目的:探讨剖宫产术后子宫瘢痕妊娠(CSP)的临床特点与不同治疗方法的疗效。方法:回顾分析2010年1月至2016年10月同济大学附属同济医院妇科收治的28例CSP患者的临床资料。根据不同治疗方案分为8组:腹腔镜下子宫瘢痕妊娠病灶切除术组2例,宫腔镜下子宫瘢痕妊娠病灶切除术组2例,阴式子宫瘢痕妊娠病灶切除术组2例,子宫动脉栓塞+清宫术组11例,子宫动脉栓塞+宫腔镜下子宫瘢痕妊娠病灶切除术组1例,清宫术组5例,单纯药物治疗组2例,经腹子宫瘢痕妊娠病灶切除术组3例,并进行一定的归纳与总结。结果:手术均取得较好疗效,无一例患者因难治性大出血切除子宫。结论:单纯药物治疗、清宫术、宫腔镜手术治疗CSP存在大出血风险,不作为首选治疗方案,联合UAE可降低发生大出血的风险,腹腔镜手术、经腹手术、阴式手术治疗CSP疗效确定,且阴式手术费用相对较低。
[Abstract]:Objective: to investigate the clinical characteristics and therapeutic effects of (CSP) in uterine scar pregnancy after cesarean section. Methods: the clinical data of 28 patients with CSP admitted to Tongji Hospital affiliated to Tongji University from January 2010 to October 2016 were analyzed retrospectively. According to different treatment schemes, they were divided into 8 groups: laparoscopic hysterectomy group (2 cases), hysteroscopic hysterectomy group (2 cases), vaginal uterine scar pregnancy lesion resection group (2 cases), laparoscopic hysterectomy group (2 cases), hysteroscopic hysterectomy group (2 cases). There were 11 cases in uterine artery embolism group, 1 case in hysteroscopic hysterectomy group, 5 cases in clearing uterus group, 2 cases in simple drug treatment group and 3 cases in abdominal uterine scar pregnancy lesion resection group. And carry on certain induction and summary. Results: the operation achieved good results, and no patient underwent hysterectomy due to refractory massive bleeding. Conclusion: simple drug therapy, hysteroscopy and hysteroscopy in the treatment of CSP have the risk of massive bleeding, not as the first choice of treatment, combined with UAE can reduce the risk of massive bleeding, laparoscopic surgery, transabdominal surgery. The curative effect of yin operation on CSP was determined, and the cost of yin operation was relatively low.
【作者单位】：同济大学附属同济医院;上海市第五人民医院;
【分类号】：R714.22

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