中国妇幼健康研究2012，Vol.23Issue(3)：383-385,3.DOI:10.3969/j.issn.1673-5293.2012.03.051
剖宫产术后瘢痕妊娠的个体化治疗方法探讨
Exploration of individualized therapy for cesarean scar pregnancy
程彦君 1黄靖然 1许兴桂1
作者信息
- 1. 深圳市龙岗中心医院妇产科,广东,深圳,518116
- 折叠
摘要
Abstract
Objective To analyze the clinical features of cesarean scar pregnancy( CSP )and explore the methods for early diagnosis and individualized treatment for it. Methods The clinical data and diagnosis and treatment of 32 cases with CSP were analyzed retrospectively. Results All cases had amenorrhoea and 23 cases had vaginal bleeding from spotting to moderate degree. Four cases were misdiagnosed as normal early intrauterine pregnancy or inevitable abortion and were treated with dilation and curettage or medical abortion. There were 15 cases with mild lower abdominal pain. There were 28 cases diagnosed by transvaginal B-ultrasound or color ultrasonography, and 4 cases diagnosed by MRI. Six cases ( 18. 8% ) received drug conservative therapy because of low level of blood β-hCG, 18 cases ( 56. 3% ) were treated with uterine artery embolization plus curettage because of more vaginal bleeding, and 8 cases ( 25. 0% ) received laparoscope treatment or scar tissue excision and neoplasty by laparotomy because of large scar with deep implantation. All cases were cured and blood β-hCG was followed up till it came to normal level. The difference in average stay among patients with conservative therapy, patients with uterine artery embolization plus curettage and patients with surgery was statistically significant ( F = 25. 96, P < 0. 05 ). Conclusion Transvaginal sonography is an effective method to diagnose CSP, and individualized therapy should be selected according to situation of patients. Reasonable application of MTX and mifepristone, uterine artery embolization plus curettage, scar tissue excision and neoplasty can obtain good therapeutic efficacy.关键词
剖宫产术/瘢痕妊娠/早期诊断/个体化治疗Key words
cesarean section/scar pregnancy/ early diagnosis/individualized therapy分类
医药卫生引用本文复制引用
程彦君,黄靖然,许兴桂..剖宫产术后瘢痕妊娠的个体化治疗方法探讨[J].中国妇幼健康研究,2012,23(3):383-385,3.
