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

全文 ( ) 下载PDF ( ) 导出引用

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

[1]	Ren T, Zhao J, Wan XR, et al. Diagnosis and treatment of cesarean scar pregnancy[J]．Prog Obstet Gynecol, 2007，16(6):433-436.
[2]	Maymon R, Halperin R, Mendlovic S, et al.Ectopic pregnancies in a caesarean scar：Review of the medical approach to an iatrogenic complication[J]．Hum Peprod Update，2004，10(6):515-523.
[3]	Vial Y, Petignat P, Hohlfeld P．Pregnancy in a cesarean scar[J]．Ultrasound Obstet Gynecol，2000，16(6):592-593.
[4]	Wang JH, Xu KH, Lin J, et al.Methotrexate therapy for cesarean section scar pregnancy with and without section curettage[J]．Feril Steril，2009，92(4):1208-1213.
[5]	Wan J, Gu WJ, Wang HY, et al.Clinical application of bilateral uterine arterial chemoembolization in the treatment of massive hemorrhage due to cesarean scar pregnancy[J]．J Int Radiol, 2009，18(7):499-502.
[6]	Wang Y, Meng F, Li J, et al. Uterine artery chemoembolization combined with uterine curettage under laparoscopic monitor for cesarean scar pregnancy[J]. Chin J Med Imaging Technol，2010，26(12):2364-2366.
[7]	Dean R, Abbot J．Hystemscopic management of cesarean scar ectopic pregnancy[J]．Fertil Steril，2010，93(6):1735-1740.
[8]	Lee JH, Kim SH, Cho SH, et al.Laparoscopic surgery of ectopic gestational sac implanted in the cesarean section scar[J]．Surg Laparosc Endosc Percutan Tech，2008，18(5):479-482.

[1]	陈向军, 于丽, 王星, 梁俊青, 吴迪, 李志军. 采用不同方法联合放射治疗修复薄型瘢痕疙瘩的临床疗效分析[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(03): 215-222.
[2]	陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[3]	刘连新, 孟凡征. 不断提高腹腔镜解剖性肝切除的规范化[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(04): 355-358.
[4]	刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[5]	蒋凤茹, 朱熠林. 双腔造瘘口旁疝诊疗经验[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 534-537.
[6]	仝聪, 周哲琦, 阎立昆. 食管裂孔疝合并胃食管反流病治疗现状及与胃食管结合部肿瘤的关系[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 491-493.
[7]	翁桂湖, 刘悦泽, 张太平. 胰腺神经内分泌肿瘤治疗进展与争议[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 602-606.
[8]	邱小原, 刘雨馨, 李珂璇, 林国乐, 邱辉忠, 安燚. 直肠肿瘤术后直肠阴道瘘的外科治疗[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 423-430.
[9]	曲洋, 蒋浩然, 邢博涵, 张蒙, 张培训. 肩袖损伤的治疗进展[J/OL]. 中华肩肘外科电子杂志, 2024, 12(04): 289-291.
[10]	曹文钰, 郭鹏, 李锦平. 微创手术及非手术方式治疗慢性硬膜下血肿的研究进展[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 304-309.
[11]	李晓东, 李昂, 马龙, 刘亮, 魏云, 王汉宇. 基底动脉顶端动脉瘤显微手术治疗[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(04): 254-256.
[12]	赖丽, 尧小龙, 李俊. 烟雾病合并血流相关性动脉瘤二例报道并文献复习[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(02): 122-125.
[13]	陈仁杰, 鲁谊. 肘关节骨关节炎手术治疗进展[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(01): 57-64.
[14]	景方坤, 周建波, 王全才, 黄海韬, 李岩峰, 徐杨熙. 神经导航引导下治疗基底节高血压脑出血的短期疗效预测[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 154-159.
[15]	刘虎, 任振, 韦笑韩, 潘晨, 吴立胜. 胃食管反流伴食管运动障碍的诊疗进展[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 153-158.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

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

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

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