Foley水囊在剖宫产后瘢痕部位妊娠治疗中的临床价值

The clinical value of Foley bladder in the treatment of the cesarean scar pregnancy

目的:探讨在剖宫产术后瘢痕部位妊娠(Cesarean scar pregnancy,CSP)治疗中Foley水囊的应用价值。方法:回顾分析本院4年间(2006年1月～2009年12月)收治20例剖宫产术后瘢痕部位妊娠,经过甲氨蝶呤(MTX)+米非司酮药物治疗后,血清人绒毛膜促性腺激素(β-Serum human chorionic gonadotropin,β-HCG)下降至5000IU/L以下在超声引导下行刮宫术和子宫下段Foley水囊压迫法止血。结果:17例刮宫术中平均出血量(279.0±63.9)ml,Foley水囊压迫后出血量平均为(65.0±19.8)ml;Foley水囊在子宫的存留时间平均为(38.0±11.1)h,17例治愈出院;1例全子宫切除、1例次全子宫切除、1例子宫瘢痕部位锲形切除。结论:Foley水囊压迫法在子宫瘢痕部位妊娠治疗中,对预防刮宫术后出血是有效的,特别在基层医院有一定的临床应用价值。

Objective：To explore the clinical value of Foley bladder in the treatment of the cesarean scar pregnancy（CSP）.Methods： Twenty patients with CSP in Chongqing Health Center for Women and Children from Jan 2006 to Dec 2009 were stutied.All patients were treated with Methotrexate（MTX）and mifepristone.When theirβ-Serum human chorionic gonadotropin（β-HCG）were under 5000IU /L,they were undertaken curettage guided by ultrasound and hemostasis with Foley bladder.Results：Seventeen patients were cured,and the amount of bleeding was 279.0±63.9 ml in curettage,（65±19.8）ml after performed Foley bladder,The Foley bladder were held in the uterine cavity for（38±11.1）hours.The other cases included one patient of total hysterectomy,one patient of subtotal hysterectomy and one patient of uterine scar excision.Conclusions：The hemostasis with Foley bladder is a valuable treatment for CSP patients with the Primary Hospital of less bleeding,less cost and protecting the pregnancy.