经腹部超声监测下清宫术治疗剖宫产术后子宫瘢痕妊娠临床分析.docVIP

经腹部超声监测下清宫术治疗剖宫产术后子宫瘢痕妊娠临床分析 　　【摘要】 目的：探?经腹部超声监测下清宫术治疗剖宫产瘢痕妊娠（CSP）的临床效果。方法：回顾分析2008年1月-2016年7月本院收治的行经腹部超声监测下清宫术治疗的102例CSP患者的临床资料。其中101例为首诊治疗，1例为外院治疗失败转入本院，所有患者入院后行血β-hCG测定，阴式三维彩超检查。结果：除1例清宫后加用甲氨蝶呤（MTX）外，其余101例患者均经清宫术治愈，均未行紧急输血治疗或子宫动脉栓塞术。平均妊娠天数为（46.0±13.0）d，子宫下段前壁剖宫产瘢痕处肌层厚度为（5.5±2.1）mm，平均术中出血量为（71.0±34.0）mL，术后血β-hCG恢复正常的时间为（38.0±11.0）d，平均住院时间为（2.6±1.8）d，平均住院费用为（2534.0±558.0）元。结论：对子宫下段前壁剖宫产瘢痕处肌层厚度（孕囊与膀胱之间肌层厚度）大于3 mm、停经天数≤70 d的内生型的患者，行经腹部超声监测下清宫术治疗CSP患者的初诊病例，选择经腹部超声监测下直接清宫是较为安全、有效、实用的方法 【关键词】 剖宫产瘢痕妊娠； 清宫术； 瘢痕处肌层厚度； 腹部超声监测 Clinical Analysis of Abdominal Ultrasound Monitoring Curettage in Treatment of Cesarean Scar Pregnancy/LU Hai-yan，LUO Zhong-han，HUANG Yan，et al.//Medical Innovation of China，2017，14（09）：088-092 【Abstract】 Objective：To investigate the clinical effect of abdominal ultrasound monitoring curettage in treatment of cesarean scar pregnancy（CSP）.Method：In a retrospective study，102 women with endogenous CSP underwent suction curettage alone guided with transabdominal ultrasound in our hospital from January 2008 to July 2016.101 patients who received transabdominal sonography-guided dilation and curettage as the primary treatment for CSP，and 1 woman was transferred from other hospital with failed treatment of CSP.Serum β-human chorionic gonadotropin（β-hCG） levels and transvaginal ultrasound results were collected among all patients on admission.Result：Among 102 patients，101 women with CSP were successfully treated with transabdominal sonography-guided dilation and curettage，and 1 woman was added with Methotrexate（MTX） after the suction and curettage.No woman required emergency blood transfusion or uterine artery embolization.The average duration of amenorrhea were（46.0±13.0）days，the average myometrium thickness in the cesarean scar at the anterior uterine wall were（5.5±2.1）mm，the average blood loss during suction and curettage were （71.0±34.0）mL，the mean time for achieving a normal β-hCG levels were （38.0±11.0）days，the average hospital stays were （2.6±1