宫腔镜监测下清宫术治疗剖宫产瘢痕妊娠.pdfVIP

《激光杂志 清宫术 2．N。．5．20，) 87 ． 宫腔镜监测下清宫术治疗剖宫产瘢痕妊娠 曹 毅，肖 琳，唐良萏 (重庆医科大学附属第一医院妇产科 ，重庆 400016) 提要：目的：探讨清宫术治疗剖宫产瘢痕妊娠的指征。方法：对 2O07—2009年在我院诊断剖宫产瘢痕妊娠、给予官腔镜辅助清宫术治疗的 患者7例进行回顾性分析，评价临床资料、B超检查、官腔镜表现与治疗效果的关系。结果：4例患者用清宫术治愈，出血不多：2例清宫不全、 补充药物治疗(MTX)后治愈；1例清宫术中出血多、急诊开腹手术行病灶切除术。成功治疗的患者宫腔镜检查表现为孕囊凸向腔内，而出血多、 治疗失败的患者孕囊植入深。结论：对妊娠物凸向宫腔内的剖宫产瘢痕妊娠，清官术是有效、简便的治疗方法，官腔镜有利于筛选合适病例。 关键词：剖宫产瘢痕妊娠；清官术；官腔镜 中图分类号：714．22 文献标识码：A 文章编号：0253—2743(20l1)05一OO87—02 Theexperienceofcaesarean scarpregnancytreatedwith suctioncurettageunderhysterocopygnidance CAOYi。XIAO Lin。TangLiang—dan (DepartmentofCynecologynadObstetrics，theFirstAffiliatedHospital，ChongqingMdeicalUniversity。Chongqing400016，China) Abstract：Objective：Todescribeourexperienceonhtetreatmentofcae8areanseFpregnancywihtsuctionandcm~ttageunderhysteroscopyguidance． Mehtods：SevenpatientsdiagnosedaScaP．~Lreansectioncsarpregnnacytreatde inourdepartmentunderwentsuctioncurettageunderhysterosocpybetween2OO7and 20O9．Mdeicalrecordsnadhy~eroocpypicturesof$~vencaseswerecollectde andreviewed．Results：Fourofthem hadcompletesuctioncra~tageandunevenftul outcome．Twohadincompleteevacuationnadsmallamountofhemorrhage．AfterSystemicMTXtreatment。~ruln口一hCGdecreasedandpregnnacyremnants disappearedprogressively．Onehad heavyhemorrhage．~parotomyw丑sperformde nad thelesionWos excised．Analysisof allhtesewomne ’shysteroocpy characteristicsrevealde htatfoursuccessfullytreatde womenhadintrauterinegestationalsacs．Onewhohadexperiencde heavyhemorrhagenadlaparotomywere wiht de印 SaCimplnatation．Conclusions：Suctioncurettageisafeasibleconservativeprocdeureforcaes．$thathad intrauterinegestationalsacs．Hysteroscopyare usefulofrscreeningsuitabl