腹腔镜子宫动脉阻断联合B超监测下清宫治疗子宫瘢痕妊娠的疗效观察（基础医学资料）.docVIP

腹腔镜子宫动脉阻断联合B超监测下清宫治疗子宫瘢痕妊娠的疗效观察（基础医学资料） 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：腹腔镜子宫动脉阻断联合B超监测下清宫治疗子宫瘢痕妊娠的疗效观察 1 1 资料与方法 3 2 结果 4 3 讨论 5 文2：剖宫产术后子宫瘢痕妊娠的临床特点及治疗 6 1 病因 6 2 诊断 6 3 鉴别诊断 8 4 治疗 8 参考文摘引言： 10 原创性声明（模板） 11 文章致谢（模板） 11 正文 腹腔镜子宫动脉阻断联合B超监测下清宫治疗子宫瘢痕妊娠的疗效观察（基础医学资料） 文1：腹腔镜子宫动脉阻断联合B超监测下清宫治疗子宫瘢痕妊娠的疗效观察 Abstract：Objective To observe the clinical efficacy of laparoscopic uterine arteries ligation combined with curettage guided by ultrasonography in treatment of cesarean scar pregnancy（CSP）. Methods Thirty cases with CSP hospitalized in gynecology department of our hospital from January 2010 to July 2015 were randomly divided into 2 groups. Patients in observation group were treated with laparoscopic uterine arteries ligation combined with curettage guided by ultrasonography. Patients in control group were treated with drug induced abortion combined with curettage guided by The observation group had a curative rate of 100%， while the curative rate was % in the control group. The amount of bleeding，the time of HCG quantitative clearance， and the time of vaginal bleeding postoperation were significantly different between the two groups（P ）.Conclusion Application of laparoscopic uterine arteries ligation combined with curettage guided by ultrasonography is effective in treatment of CSP。 Key words：Uterine arteries ligation； Curettage guided by ultrasonography；Cesarean scar pregnancy 剖宫产术后子宫瘢痕妊娠（cesarean scar pregnancy，CSP）是指受精卵着床种植在既往剖宫产子宫切口瘢痕部位的异位妊娠，可导致难治性大出血、胎盘植入、子宫破裂、膀胱穿孔，是剖宫产远期潜在的严重并发症，文献报道发生率约为%[1]。随着近年剖宫产率的明显上升， CSP的发生率也较前增加。目前治疗方法包括药物保守治疗（MTX全身用药及局部注射）、妊娠物吸引术、阴式子宫疤痕妊娠切开取胚术以及宫腔镜、腹腔镜检查和开腹孕囊取出术，但存在治疗失败、出血多、病灶清除不彻底或手术创伤大、恢复慢的不同弊端[2]。本研究采用腹腔镜子宫动脉阻断联合B超监测下清宫治疗CSP并取得良好效果，现报告如下。 1 资料与方法 一般资料 选择2010年1月～2015年7月在南海妇幼保健院妇科住院经阴道彩色超声诊断的CSP患者30例，根据统计软件产生的随机数字表以1：1比例分为观察组和对照组。 纳入标准 符合CSP的超声诊断标准[3，4]：①宫腔及宫颈管内未探及孕囊回声；②孕囊或混合性包括位于子宫峡部前壁宫颈内口水平，彩色多普勒血流成像显示孕囊血流灌注良好，区别于妊娠流产血流灌注缺失，且当阴道内探头稍加压摆动时，孕囊在子宫内口水平的位置无改变；③孕囊与膀胱之间的子宫下段前壁肌层变薄或连续性中断；④附件区未探及包块。血常