摘要
目的探讨剖宫产瘢痕妊娠的发病机制、早期诊断以及最佳的治疗方法。方法回顾分析2005年1月-2010年1月我院收治的10例剖宫产瘢痕妊娠的临床资料,包括发病年龄、孕产次、发病至剖宫产术的间隔时间、首发症状、辅助检查、治疗方法。结果我院剖宫产瘢痕妊娠与同期正常妊娠数之比为1:1028.4,占同期异位妊娠的1.6%。10例患者平均年龄(32.3±4.4)岁,发病至末次剖宫产术的平均间隔时间为(6.1±3.9)年,最常见的临床表现为停经和阴道流血。4例患者外院误诊为宫内早孕(3例)和滋养细胞肿瘤(1例),余6例均在我院治疗前确诊。治疗方法包括全身或孕囊内甲氨蝶呤(MTX)注射、宫腹腔镜下治疗以及子宫动脉栓塞治疗。全部患者均治愈出院。结论剖宫产瘢痕妊娠易误诊,应结合妇科检查及辅助检查早期诊断;个体化治疗及宫、腹腔镜联合治疗可获得满意疗效。
Objective To study the pathogenesis,early diagnosis and best treatment of cesarean scar pregnancy（CSP）.Methods Clinical data about 10 CSP patients admitted to our hospital from January 2005 to January 2010,including age,pregnancies and deliveries,interval between disease onset and cesarean,initial symptoms,auxiliary examination findings,and therapies,were retrospectively analyzed.Results Ten CSP patients at the age of 32.3±4.4 years and 10 284 normal pregnancy patients were admitted to our hospital from January 2005 to January 2010 in our hospital.Of the 620 ectopic pregnancy patients admitted,10 were CSP patients,accounting for 1.6% of all the ectopic pregnancy patients.The interval between disease onset and last cesarean was 6.1±3.9 years.The most common clinical symptoms of CSP were amenorrhea and vaginal bleeding.Of the 10 CSP patients,3 were misdiagnosed as intrauterine early pregnancy and 1 as trophocyte tumor in other hospital,6 who were diagnosed and treated in our hospital received systemic or local injection of methotrexate（MTX） and combined hysteroscopy and laparoscopy treatment.All the patients were discharged.Conclusion CSP is easy to be misdiagnosed.Its early diagnosis should be made according to the clinical and auxiliary examination findings.Individual therapy is the key to CSP.Combined hysteroscopy and laparoscopy can achieve satisfactory outcomes.
出处
《军医进修学院学报》
CAS
2010年第9期858-859,868,共3页
Academic Journal of Pla Postgraduate Medical School
关键词
妊娠并发症
宫腔镜
腹腔镜
剖宫产瘢痕妊娠
Pregnancy Complications
Hysteroscopes
Laparoscopes
Cesarean Scar Pregnancy
