摘要
目的探讨宫颈妊娠的诊断与治疗方法。方法回顾性分析2003年2月至2013年2月大连医科大学附属第一医院妇产科12例宫颈妊娠患者的临床资料。12例宫颈妊娠患者,均由妇科检查及超声明确诊断,备血静脉滴注下负压吸宫术及宫颈管搔刮术1例,单纯甲氨蝶呤(MTX)全身用药1例,MTX及米非司酮口服1例,MTX及米非司酮联合负压吸宫术及宫颈管搔刮术5例,MTX及米非司酮联合宫腔镜1例,子宫动脉栓塞术结合负压吸宫术和MTX局部用药2例,完全流产1例。随诊血人绒毛膜促性腺激素(HCG)。结果 12例患者均治疗成功,有效保留了患者生育能力,术后恢复较好,出院后随访至血HCG转阴。9例患者负压吸宫术和(或)宫颈管搔刮术和(或)宫腔镜刮出物和(或)完全流产物均送病理检查,均见变性坏死绒毛及蜕膜组织,均取得良好疗效。结论超声检查是诊断宫颈妊娠常用方法。依据妇科、超声检查结果及血HCG选择合适的治疗方法,多种方法联合治疗疗效更加可靠。
Objective To discuss the diagnosis and treatment of cervical pregnancy.Methods A retrospective analysis was conducted on the clinical data in 12 cases of cervical pregnancy admitted to the obstetric and gynecologic department of this hospital from Februrary 2003 to Februrary 2013.12 cases of cervical pregnancy were diagnosed by the gynecological examination and transvaginal ultrasound.1 case used negative pressure suction and endocervical curettageunder blood preparation and infusion,1 case was treated by the systemic adminstration of methotrexate（MTX） alone,1 case used MTX combined with oral mifepristone,5 cases used MTX combined oral mifepristone and negative pressure suction plus endocervical curettage;1 case used MTX and mifepristone combined with hysteroscopy;2 cases used uterine artery emboliszation combined with negative pressure suction and local application of MIX and 1 case was complete abortion.Blood human chorionic gonadotropin（HCG） was followed up.Results 12 cases all succeeded for therapy and effectively retained the fertility ability with good postoperative recovery.After discharge from hospital,blood β-HCG was followed up to the negative convession.The tissues scratched out from the uterus and abortuses of complete abortion in 9 cases of negative pressure suction and（or） endocervical curettage and（or） hysteroscopyall were performed the pathological examination and the results showed that the degenerative and necrosis villus and decidual tissues were found.All cases got better curative effects.Conclusion Transvaginal ultrasound is a common method for diagnosing cervical pregnancy.According to the gynecological examination,ultrasound results and blood HCG,the suitable treatment method should be selected.The combination therapy of multiple methods can obtain the effect more reliable.
出处
《现代医药卫生》
2013年第14期2112-2113,共2页
Journal of Modern Medicine & Health
关键词
妊娠
异位
子宫颈
甲氨蝶呤
米非司酮
栓塞
治疗性
子宫
血液供给
宫腔镜检查
Pregnancy
ectopic
Cervix uteri
Methotrexate
Mifepristone
Embolization
therapeutic
Uterus/ blood supply
Hysteroscopy
