国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
6期
756-758
,共3页
剖宫产瘢痕%妊娠%个体化治疗
剖宮產瘢痕%妊娠%箇體化治療
부궁산반흔%임신%개체화치료
Cesarean scar%Pregnancy%Individualized treatment
目的 探讨剖宫产瘢痕妊娠的发病机制、诊断和治疗方法.方法 回顾性分析2000年1月-2011年1月我院收治的129例剖宫产瘢痕妊娠患者的临床资料.结果 129例患者中,一次剖宫产史98例,二次剖宫产史31例.所有患者阴道超声或彩色多普勒超声检查,结合血β -hCG水平确诊.35例患者单纯药物治疗,成功率100％.药物加手术治疗38例,33例成功,出血量15～ 130 ml,平均45 ml,成功率86.8％;5例因CSP破裂阴道大出血行全子宫切除术.子宫动脉栓塞术(UAE)治疗56例,50例成功,成功率89.3％.住院时间5～20天,治疗后15～30天β -HCG降至5mIU/ml以下；6例因子宫血管畸形导致刮宫时大出血,行手术治疗.结论 剖宫产瘢痕妊娠患者应结合妇科检查及辅助检查以早期诊断,根据患者情况予以个体化治疗,可获得较好疗效.
目的 探討剖宮產瘢痕妊娠的髮病機製、診斷和治療方法.方法 迴顧性分析2000年1月-2011年1月我院收治的129例剖宮產瘢痕妊娠患者的臨床資料.結果 129例患者中,一次剖宮產史98例,二次剖宮產史31例.所有患者陰道超聲或綵色多普勒超聲檢查,結閤血β -hCG水平確診.35例患者單純藥物治療,成功率100％.藥物加手術治療38例,33例成功,齣血量15～ 130 ml,平均45 ml,成功率86.8％;5例因CSP破裂陰道大齣血行全子宮切除術.子宮動脈栓塞術(UAE)治療56例,50例成功,成功率89.3％.住院時間5～20天,治療後15～30天β -HCG降至5mIU/ml以下；6例因子宮血管畸形導緻颳宮時大齣血,行手術治療.結論 剖宮產瘢痕妊娠患者應結閤婦科檢查及輔助檢查以早期診斷,根據患者情況予以箇體化治療,可穫得較好療效.
목적 탐토부궁산반흔임신적발병궤제、진단화치료방법.방법 회고성분석2000년1월-2011년1월아원수치적129례부궁산반흔임신환자적림상자료.결과 129례환자중,일차부궁산사98례,이차부궁산사31례.소유환자음도초성혹채색다보륵초성검사,결합혈β -hCG수평학진.35례환자단순약물치료,성공솔100％.약물가수술치료38례,33례성공,출혈량15～ 130 ml,평균45 ml,성공솔86.8％;5례인CSP파렬음도대출혈행전자궁절제술.자궁동맥전새술(UAE)치료56례,50례성공,성공솔89.3％.주원시간5～20천,치료후15～30천β -HCG강지5mIU/ml이하；6례인자궁혈관기형도치괄궁시대출혈,행수술치료.결론 부궁산반흔임신환자응결합부과검사급보조검사이조기진단,근거환자정황여이개체화치료,가획득교호료효.
Objective To explore the pathogenesis,early diagnosis and individualized treatment for cesarean scar pregnancy.Methods The clinical data of 129 cases with cesarean scar pregnancy from January 2000 to January 2011 were analyzed retrospectively.Results 98 patients had history of cesarean delivery once,and 31 patients twice.All patients were diagnosed as asymptomatic cesarean scar pregnancy definitely by vaginal ultrasound and color Doppler ultrasonography,combined with serum β - hCG level diagnosis.35 cases were treated with drug,with the success rate of 100％,38 cases were treated with drug plus operation,33 cases were successful,,bleeding volume of about 15 ～ 130 ml,average 45 ml, with the success rate of 86.8％.5 cases received total hysterectomy because of CSP rupture vagina bleeding 1 month later.56 cases were treated by Uterine artery embolization (UAE),50 cases were successful,with the success rate of 89.3％.Hospitalization time is 5 ～ 20 days,β -hCG decreased to 5 mIU / nd after 15 ～ 30 days below.6 cases with pregnancy for 7 weeks were treated with surgical operation because of uterine vascular malformations causing hemorrhage.Conclusion The early diagnosis is important by gynecologic and auxiliary examination,the therapeutic effect of individualized treatment is good.
