腹腔镜在治疗剖宫产后子宫瘢痕妊娠中的应用

Laparoscopy in the Treatment of Cesarean Scar Pregnancy

目的:探讨腹腔镜在治疗剖宫产后子宫瘢痕妊娠(CSP)中的应用价值。方法:回顾分析2008年3月至2011年5月经腹腔镜诊治7例CSP患者的临床资料。结果:7例患者均腹腔镜下完成手术,治愈并保留子宫,手术成功率100%,平均手术时间85.7±17.2分钟,平均手术出血量202.9±270ml,无中转开腹。6例同时行瘢痕修补,术后血人绒毛膜促性腺激素(β-HCG)降至100U/L以下时间平均14.6±5.2天,超声显示子宫恢复正常时间平均21.7±30.2天,1例未同时行瘢痕修补的患者,超声显示3个月后子宫恢复正常。结论:腹腔镜在明确CSP诊断的同时还能在阻断双侧子宫动脉后行妊娠物清除和瘢痕修补,是治疗CSP的理想方法。

Objective：to evaluate the value of laparoscope in the treatment of cesarean scar pregnancy （CSP）. Methods.The clinical data of 7 CSP patients who were treated with laparoscope from March 2008 to May 2011 were retrospectively analyzed. Results： Seven CSP patients were treated with laparoscopic surger- y, all patients were cured with reservation of the uterus. The successful rate of operation was 100% （7/7）, operation time was （85. 7 ± 17. 2） minutes and blood loss was （202.9 ± 270） ml. No conversion to lapa- rotomy was needed. Six patients received repair of cesarean scar, and the average time of serum hu- man-specific chorionic gonadotropin （β-HCG） reduced to lower than 100 U/L was （14. 6 ± 5. 2） days. the average time of uterine involution detected by ultrasound were（21.7 ± 30. 2） days. The uterus returned to normal size 3 months after surgery in one patient without repairing cesarean scar during operation. Conclusions：Laparoscopy not only can confirm the diagnosis of CSP, but also can remove pregnancy and repair the cesarean scar while blocking the uterine arteries, and there for it is an ideal method to treat CSP.