世界最新医学信息文摘（连续型电子期刊）
世界最新醫學信息文摘（連續型電子期刊）
세계최신의학신식문적（련속형전자기간）
World Latest Medicine Information
2015年
52期
3-4
,共2页
剖宫产后疤痕处妊娠%子宫动脉%甲氨蝶呤%动脉栓塞%清宫术
剖宮產後疤痕處妊娠%子宮動脈%甲氨蝶呤%動脈栓塞%清宮術
부궁산후파흔처임신%자궁동맥%갑안접령%동맥전새%청궁술
Cesarean scar pregnancy%uterine artery%methotrexate%arterial embolization%uterine curettage
目的：探究剖宫产术后疤痕处妊娠治疗的方法及效果。方法选取近五年收治的40例剖宫产术后疤痕处妊娠患者，所有患者均采取双侧子宫动脉甲氨蝶呤灌注化疗及明胶海绵颗粒栓塞，并在术后3~7天进行清宫术，记录术中的出血量，并将刮出物送病理进行检查，清宫术结束后1周进行阴道彩超检查，复查血β-HCG。结果40例患者均顺利完成介入治疗，术后阴道停止出血，孕囊显著缩小，血β-HCG明显下降。进行术后清宫时患者出血量减少，刮出物进行病理检查显示出绒毛组织，出现不同程度的变性或是坏死；进行彩超检查后子宫疤痕处未见异常的回声及血流信号。结论对于剖宫产术后疤痕妊娠患者给予双侧子宫动脉甲氨蝶呤联合栓塞治疗，并进行清宫术能够收到很好的治疗效果，明显地减小了孕囊，有效降低血β-HCG水平；最大限度地控制子宫出血情况，为患者保留子宫，成为治疗剖宫产术后疤痕处妊娠的有效方法，值得在临床推广应用。
目的：探究剖宮產術後疤痕處妊娠治療的方法及效果。方法選取近五年收治的40例剖宮產術後疤痕處妊娠患者，所有患者均採取雙側子宮動脈甲氨蝶呤灌註化療及明膠海綿顆粒栓塞，併在術後3~7天進行清宮術，記錄術中的齣血量，併將颳齣物送病理進行檢查，清宮術結束後1週進行陰道綵超檢查，複查血β-HCG。結果40例患者均順利完成介入治療，術後陰道停止齣血，孕囊顯著縮小，血β-HCG明顯下降。進行術後清宮時患者齣血量減少，颳齣物進行病理檢查顯示齣絨毛組織，齣現不同程度的變性或是壞死；進行綵超檢查後子宮疤痕處未見異常的迴聲及血流信號。結論對于剖宮產術後疤痕妊娠患者給予雙側子宮動脈甲氨蝶呤聯閤栓塞治療，併進行清宮術能夠收到很好的治療效果，明顯地減小瞭孕囊，有效降低血β-HCG水平；最大限度地控製子宮齣血情況，為患者保留子宮，成為治療剖宮產術後疤痕處妊娠的有效方法，值得在臨床推廣應用。
목적：탐구부궁산술후파흔처임신치료적방법급효과。방법선취근오년수치적40례부궁산술후파흔처임신환자，소유환자균채취쌍측자궁동맥갑안접령관주화료급명효해면과립전새，병재술후3~7천진행청궁술，기록술중적출혈량，병장괄출물송병리진행검사，청궁술결속후1주진행음도채초검사，복사혈β-HCG。결과40례환자균순리완성개입치료，술후음도정지출혈，잉낭현저축소，혈β-HCG명현하강。진행술후청궁시환자출혈량감소，괄출물진행병리검사현시출융모조직，출현불동정도적변성혹시배사；진행채초검사후자궁파흔처미견이상적회성급혈류신호。결론대우부궁산술후파흔임신환자급여쌍측자궁동맥갑안접령연합전새치료，병진행청궁술능구수도흔호적치료효과，명현지감소료잉낭，유효강저혈β-HCG수평；최대한도지공제자궁출혈정황，위환자보류자궁，성위치료부궁산술후파흔처임신적유효방법，치득재림상추엄응용。
Objective:To explore the method and effect of treatment of scar pregnancy after cesarean section.Methods:In recent years treated40 cases after cesarean section scar pregnancy patients, all patients were taken bilateral uterine artery methotrexate infusion chemotherapy and embolization with gelfoam particles and, and curettage in 3 to 7 days after operation, intraoperative bleeding volume and scrapings send disease physical examination, uterine curettage after 1 week of transvaginal color Doppler ultrasound examination, review of serum beta hCG.Results:All40 patients were successfully treated by interventional therapy, and the vaginal bleeding after operation, the pregnancy capsule was significantly decreased, and the serum -HCG was significantly decreased. Postoperative curettage with reduced bleeding, scrapings for pathological examination showed villus tissue, have different degrees of degeneration and necrosis;color Doppler ultrasound in the diagnosis of uterine scar, no abnormal echo and blood fiow signal. Conclusion:For bilateral uterine artery methotrexate combined with embolization therapy given to patients with scar pregnancy after cesarean section, and curettage can receive good treatment effect, obviously reduces the gestational sac, effectively reduce the level of serum beta hCG; maximum control uterine bleeding, for patients to preserve the uterus, an effective method for treatment of cesarean section after caesarean scar pregnancy, it is worth in clinical application.
