中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2014年
12期
1106-1108,1111
,共4页
剖宫产瘢痕妊娠%宫腔镜%球囊
剖宮產瘢痕妊娠%宮腔鏡%毬囊
부궁산반흔임신%궁강경%구낭
Caesarean scar pregnancy%Hysteroscopy%Balloon
目的：探讨宫腔镜联合Foley双腔导尿管球囊治疗剖宫产瘢痕妊娠（ caesarean scar pregnancy ，CSP）的临床效果。方法2008年1月～2013年10月，B超确诊CSP 21例，其中11例血β－hCG 0～500 IU／L口服米非司酮后2 d手术，10例血β－hCG＞500 IU／L口服米非司酮联合注射甲氨蝶呤后7～14 d手术，均采用宫腔镜电切联合Foley双腔导尿管球囊压迫止血。结果19例一次性顺利完成宫腔镜手术，手术时间15～42 min；1例二次宫腔镜手术，1例发生子宫穿孔改腹腔镜手术。18例术前β－hCG 0～500 IU／L者，术中出血量20～100 ml；3例β－hCG 1085～2760 IU／L者术中出血量200～800 ml。16例门诊随访2～4周血β－hCG下降至正常，43～56 d恢复月经，经量无明显改变。5例电话随访，术后39～50 d月经恢复正常。结论宫腔镜电切联合球囊治疗CSP安全、有效。
目的：探討宮腔鏡聯閤Foley雙腔導尿管毬囊治療剖宮產瘢痕妊娠（ caesarean scar pregnancy ，CSP）的臨床效果。方法2008年1月～2013年10月，B超確診CSP 21例，其中11例血β－hCG 0～500 IU／L口服米非司酮後2 d手術，10例血β－hCG＞500 IU／L口服米非司酮聯閤註射甲氨蝶呤後7～14 d手術，均採用宮腔鏡電切聯閤Foley雙腔導尿管毬囊壓迫止血。結果19例一次性順利完成宮腔鏡手術，手術時間15～42 min；1例二次宮腔鏡手術，1例髮生子宮穿孔改腹腔鏡手術。18例術前β－hCG 0～500 IU／L者，術中齣血量20～100 ml；3例β－hCG 1085～2760 IU／L者術中齣血量200～800 ml。16例門診隨訪2～4週血β－hCG下降至正常，43～56 d恢複月經，經量無明顯改變。5例電話隨訪，術後39～50 d月經恢複正常。結論宮腔鏡電切聯閤毬囊治療CSP安全、有效。
목적：탐토궁강경연합Foley쌍강도뇨관구낭치료부궁산반흔임신（ caesarean scar pregnancy ，CSP）적림상효과。방법2008년1월～2013년10월，B초학진CSP 21례，기중11례혈β－hCG 0～500 IU／L구복미비사동후2 d수술，10례혈β－hCG＞500 IU／L구복미비사동연합주사갑안접령후7～14 d수술，균채용궁강경전절연합Foley쌍강도뇨관구낭압박지혈。결과19례일차성순리완성궁강경수술，수술시간15～42 min；1례이차궁강경수술，1례발생자궁천공개복강경수술。18례술전β－hCG 0～500 IU／L자，술중출혈량20～100 ml；3례β－hCG 1085～2760 IU／L자술중출혈량200～800 ml。16례문진수방2～4주혈β－hCG하강지정상，43～56 d회복월경，경량무명현개변。5례전화수방，술후39～50 d월경회복정상。결론궁강경전절연합구낭치료CSP안전、유효。
Objective To investigate the clinical effect of hysteroscopy combined with foley balloon tamponade in the management of caesarean scar pregnancy ( CSP ) . Methods Twenty-one cases were diagnosed as having CSP by ultrasound examinations from January 2008 to November 2013.Among them, 11 cases with serum β-hCG below 500 IU/L underwent the surgery after taking mifepristone for 2 days, while 10 cases with serum β-hCG over 500 IU/L underwent surgery after injection of MTX combined with oral administration of mifepristone for 7 -14 days.All the cases were treated by hysteroscopy combined with foley balloon tamponade . Results The hysteroscopic operation was successfully conducted in 19 of 21 cases, with the operate time ranged 15-42 min.One case was given a second hysteroscopy and one case required a secondary laparoscopic procedure for the uterine perforation.In 18 cases with preoperative serum β-hCG below 500 IU/L, the intraoperative blood loss was 20 -100 ml, while in another 3 cases with preoperative serum β-hCG 1085-2760 IU/L, the blood loss was 200-800 ml.Follow-up examinations at clinic for 2-4 weeks in 16 cases showed levels of β-hCG declined to normal and recovery of menstruation at 43-56 postoperative days with normal menses amount . Conclusion Hysteroscopy combined with foley balloon tamponade in the management of CSP offers advantages of safety and effectiveness , which is deserved to clinical application .
