CAJ | 학술논문

目的探讨剖宫产术后子宫疤痕妊娠的诊断与治疗.方法回顾性总结分析广东省妇幼保健院2012年1月至2013年10月收治的子宫疤痕妊娠共42例.结果 42例患者初诊误诊率达33.3％.1例单纯药物治疗痊愈;6例直接行B超监测下清宫术痊愈;29例药物治疗后行宫腔镜及B超监测下行清宫术,其中26例痊愈出院,1例术后血HCG下降欠理想拒绝继续治疗签字出院,1例出血多中转开腹行子宫局部病灶切除及子宫修补术,1例出血多中转开腹行全子宫切除术;1例行药物治疗及子宫动脉栓塞术后行B超监测下行清宫术,痊愈出院;3例直接行子宫局部病灶切除及子宫修补术;2例因腹腔内出血伴休克入院,直接行急诊全子宫切除术.结论早期诊断,采取及时适当的治疗方法,有利于保留患者的生育能力,改善其预后.
목적 탐토부궁산술후자궁파흔임신적진단여치료.방법 회고성총결분석광동성부유보건원2012년1월지2013년10월수치적자궁파흔임신공42례.결과 42례환자초진오진솔체33.3％.1례단순약물치료전유;6례직접행B초감측하청궁술전유;29례약물치료후행궁강경급B초감측하행청궁술,기중26례전유출원,1례술후혈HCG하강흠이상거절계속치료첨자출원,1례출혈다중전개복행자궁국부병조절제급자궁수보술,1례출혈다중전개복행전자궁절제술;1례행약물치료급자궁동맥전새술후행B초감측하행청궁술,전유출원;3례직접행자궁국부병조절제급자궁수보술;2례인복강내출혈반휴극입원,직접행급진전자궁절제술.결론 조기진단,채취급시괄당적치료방법,유리우보류환자적생육능력,개선기예후.
Objective To explore the diagnosis and treatments of cesarean scars pregnancy.Method Analysis was conducted on 42 cases of cesarean scars pregnancy in Guangdong Women and Children Hospital from January 2012 to October 2013.Results 33.3％ of all patients were misdiagnosed at first time.1 case was cured by drugs of combination of MTX and mifepristone.6 cases were cured by curettage under ultrasound.29 cases underwent curettage under hysterscope and ultrasound after pretreatment of drugs,including 26 cases cured,1 case refusing further treatment without ideal reduction of HCG level,1 case turning to lesion resection,and 1 case turning to hysterectomy.1 case underwent curettage under ultrasound after pretreatment of drugs and uterine infarction.3 cases underwent lesion resection directly.2 cases underwent hysterectomy directly because of serious bleeding and shock.Conclusion Early diagnosis and proper treatment help to keep uterus and improve prognosis.