中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2014年
1期
18-21
,共4页
石军荣%秦金金%王伟明%张惠
石軍榮%秦金金%王偉明%張惠
석군영%진금금%왕위명%장혜
妊娠,异位%瘢痕%栓塞,治疗性%刮宫术%妇科外科手术
妊娠,異位%瘢痕%栓塞,治療性%颳宮術%婦科外科手術
임신,이위%반흔%전새,치료성%괄궁술%부과외과수술
Pregnancy,ectopic%Cicatrix%Embolization,therapeutic%Dilatation and curettage%Gynecologic surgical procedures
目的 探讨剖宫产术后子宫瘢痕妊娠(CSP)的治疗方法及临床处理中可能出现的问题.方法 对2011年1月至2013年1月就诊于河北大学附属医院并符合CSP诊断标准的57例患者的临床资料进行回顾性分析.其中12例行清宫术(清宫组),22例行子宫动脉栓塞术(栓塞组),8例行开腹病灶清除术(开腹组),15例行阴式病灶清除术(阴式组).结果 (1)清宫组、栓塞组、开腹组、阴式组治疗成功率分别为12/12、86％(19/22)、7/8、13/15.(2)清宫组中位术中出血量为20 ml(17～28ml)、住院时间为(5.1±1.9)d,栓塞组分别为10 ml(5～ 15 ml)、(10.2±3.2)d,开腹组分别为200 ml(80～300 ml)、(11.3±3.3)d,阴式组分别为50 ml(45 ～100 ml)、(6.8±1.2)d,清宫组与栓塞组比较,差异均有统计学意义(P＜0.05),开腹组与阴式组比较,差异也均有统计学意义(P＜0.05).结论 清宫术、子宫动脉栓塞术、开腹及阴式病灶清除术均可用于治疗CSP.若病灶植入肌层＞ 1/2或近浆膜层,需慎重选择介入手术；若病灶较大且周围血流信号丰富,慎重选择阴式手术.
目的 探討剖宮產術後子宮瘢痕妊娠(CSP)的治療方法及臨床處理中可能齣現的問題.方法 對2011年1月至2013年1月就診于河北大學附屬醫院併符閤CSP診斷標準的57例患者的臨床資料進行迴顧性分析.其中12例行清宮術(清宮組),22例行子宮動脈栓塞術(栓塞組),8例行開腹病竈清除術(開腹組),15例行陰式病竈清除術(陰式組).結果 (1)清宮組、栓塞組、開腹組、陰式組治療成功率分彆為12/12、86％(19/22)、7/8、13/15.(2)清宮組中位術中齣血量為20 ml(17～28ml)、住院時間為(5.1±1.9)d,栓塞組分彆為10 ml(5～ 15 ml)、(10.2±3.2)d,開腹組分彆為200 ml(80～300 ml)、(11.3±3.3)d,陰式組分彆為50 ml(45 ～100 ml)、(6.8±1.2)d,清宮組與栓塞組比較,差異均有統計學意義(P＜0.05),開腹組與陰式組比較,差異也均有統計學意義(P＜0.05).結論 清宮術、子宮動脈栓塞術、開腹及陰式病竈清除術均可用于治療CSP.若病竈植入肌層＞ 1/2或近漿膜層,需慎重選擇介入手術；若病竈較大且週圍血流信號豐富,慎重選擇陰式手術.
목적 탐토부궁산술후자궁반흔임신(CSP)적치료방법급림상처리중가능출현적문제.방법 대2011년1월지2013년1월취진우하북대학부속의원병부합CSP진단표준적57례환자적림상자료진행회고성분석.기중12례행청궁술(청궁조),22례행자궁동맥전새술(전새조),8례행개복병조청제술(개복조),15례행음식병조청제술(음식조).결과 (1)청궁조、전새조、개복조、음식조치료성공솔분별위12/12、86％(19/22)、7/8、13/15.(2)청궁조중위술중출혈량위20 ml(17～28ml)、주원시간위(5.1±1.9)d,전새조분별위10 ml(5～ 15 ml)、(10.2±3.2)d,개복조분별위200 ml(80～300 ml)、(11.3±3.3)d,음식조분별위50 ml(45 ～100 ml)、(6.8±1.2)d,청궁조여전새조비교,차이균유통계학의의(P＜0.05),개복조여음식조비교,차이야균유통계학의의(P＜0.05).결론 청궁술、자궁동맥전새술、개복급음식병조청제술균가용우치료CSP.약병조식입기층＞ 1/2혹근장막층,수신중선택개입수술；약병조교대차주위혈류신호봉부,신중선택음식수술.
Objective To investigate treatment of caesarean scar pregnancy (CSP) and associated problem.Methods From January 2011 to January 2013,57 cases with CSP undergoing treatment in Affiliated Hospital of Hebei University were studied retrospectively.Among 57 patients,it was divided into 12 cases treated by curettage (curettage group) ;22 cases treated by uterine artery embolization(embolization group) ;8 cases treated by laparotomy(laparotomy group) and 15 cases treated by transvaginal debridement (transvaginal group).Results (1) Successful rate of curettage group,embolization group,laparotomy group and transvaginal group were 12/12,86％ (19/22),7/8,13/15.(2) The intraoperative blood loss and the hospital stay were 20 (17-28) ml,(5.1 ± 1.9) days in curettage group,10 (5-15) ml,(10.2 ± 3.2) days in embolization group,200 (80-300) ml,(11.3 ± 3.3) days in laparotomy group,50 (45-100) ml,(6.8 ± 1.2) days in transvaginal group.There was statistically different between curettage group and embolization group (P ＜ 0.05).There was statistically different between laparotomy group and transvaginal group (P ＜ 0.05).Conclusions Curettage,uterine artery embolization,abdominal and transvaginal scar debridement surgery can be used in treatment of the CSP.It should be carefully chosen with surgical intervention,if myometrium was implanted greater than 1/2,or near to serosa.It should be carefully chosen with vaginal surgery,if the blood flow signals was rich around the lesion.
