经阴道子宫下段切开取胚术合并子宫缺陷修补术治疗剖宫产疤痕妊娠的疗效分析

doi:10.3877/cma.j.issn.1673-5250.2013.01.021

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (01) : 90 -93. doi: 10.3877/cma.j.issn.1673-5250.2013.01.021

所属专题：文献；

论著

经阴道子宫下段切开取胚术合并子宫缺陷修补术治疗剖宫产疤痕妊娠的疗效分析

王中海¹, 乐爱文¹, 卓蓉¹, 肖天慧¹, 熊慧娟¹, 单莉莉¹^,^*^,^*(

)

^1. 518052　广东深圳，广东医学院附属南山医院

收稿日期:2012-10-31 修回日期:2013-01-05 出版日期:2013-02-01
通信作者: 单莉莉

Transvaginal Removal of Ectopic Pregnancy Tissue and Repair of Uterine Defect for Caesarean Scar Pregnancy

Zhong-hai WANG¹, Ai-wen LE¹, Rong ZHUO¹, Tian-hui XIAO¹, Hui-juan XIONG¹, Li-li SHAN¹()

^1. Nanshan Affiliated Hospital of Guangdong Medical College, Shenzhen 518052, Guangdong Province, China

Received:2012-10-31 Revised:2013-01-05 Published:2013-02-01
Corresponding author: Li-li SHAN
About author:
Corresponding author: SHAN Li-li, Email: shanlili1977@163.com

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目的

探讨经阴道子宫下段切开取胚术＋子宫缺陷修补术治疗剖宫产疤痕妊娠(CSP)的临床价值。

方法

选择2011年7月至2012年2月于本院确诊并住院治疗的14例CSP患者为研究对象，对其采用经阴道子宫下段切开取胚术＋子宫缺陷修补术治疗(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。

结果

本组患者手术成功率为100%(14/14)。术后1 d出现血清人绒毛膜促性腺激素(hCG)水平显著下降患者为12例(85.7%)，且本组所有患者血清hCG水平均于术后1个月恢复正常。

结论

经阴道子宫下段切开取胚术＋子宫缺陷修补术治疗CSP具有安全、有效、微创、经济的优点。

关键词: 剖宫产疤痕妊娠, 手术治疗

Objective

To study the clinical value of transvaginal removal of ectopic pregnancy tissue and repair of uterine defect for caesarean scar pregnancy(CSP).

Methods

From September 2011 to Febuary 2012, 14 patients with CSP were included in the study, and accepted the transvaginal removal of ectopic pregnancy tissue and repair of a uterine defect surgery. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Nanshan Affiliated Hospital of Guangdong Medical College.Informed consent was obtained from each patients.

Results

The success rate of operation was 100.0%(14/14). There were 12 patients(85.7%) whose serum human chorionic gonadotrophin (hCG) level had significant decrease at first day after operation. The serum hCG level of all patients became normal within 1 month after operation in the study.

Conclusions

The transvaginal removal of ectopic pregnancy tissue and repair of the uterine defect is safe, effective, minimally invasive and economical for patients with CSP.

Key words: caesarean scar pregnancy, operation treatment

图1 剖宫产疤痕妊娠超声图像

Figure 1 Ultrasound image of CSP

图2 剖宫产疤痕妊娠MRI图像

Figure 2 Magnetic resonance imaging of CSP

图3 暴露子宫下段

Figure 3 Lower uterine segment

图4 切开子宫下段，见绒毛组织

Figure 4 Transvaginal removal of ectopic pregnancy tissue

图5 修补、缝合子宫下段

Figure 5 Repairing lower uterine segment

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Transvaginal Removal of Ectopic Pregnancy Tissue and Repair of Uterine Defect for Caesarean Scar Pregnancy

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Transvaginal Removal of Ectopic Pregnancy Tissue and Repair of Uterine Defect for Caesarean Scar Pregnancy