腹腔镜治疗剖宫产瘢痕妊娠

Clinical research of laparoscopy in the treatment of cesarean scar pregnancy

目的探讨腹腔镜技术治疗剖宫产瘢痕妊娠（CSP）的价值。方法回顾性分析2009年6月至2011年6月在南方医科大学附属南海人民医院住院治疗的14例剖宫产瘢痕妊娠患者,其中6例患者因血β-人绒毛膜促性腺激素较高,平均24 271.5 U/L,阴道彩超提示：子宫增大,剖宫产切口部位见孕囊或不均质中低回声包块,长径3.3～4.8 cm,平均4.1 cm,包块周围有丰富血流信号,均突向浆膜层。6例患者均采用腹腔镜下子宫瘢痕部位病灶切除术＋子宫修补术治疗。结果 6例均顺利完成手术,出血少,避免子宫切除术,达到微创、有效、恢复快的治疗效果。结论 CSP行腹腔镜下局部病灶切除＋子宫修补术不仅可以有效终止妊娠,同时可以修补瘢痕缺陷、修复子宫,保留生育功能,是一种有价值的方法。

Objective To investigate the application value of laparoscopy on cesarean scar pregnancy（CSP）. Methods Four-teen patients with CSP in this hospital from June 2009 to June 2011 were selected. Six of them had β-HCG average 24 271. 5 U/ L in blood. Their transvaginal sonography showed large uterus and gestational Sac or hypoechonic masses which were 3. 3 ～ 4. 8 cm （4. 1 cm average）with rich blood. The clinical data and treatment outcome of 6 patients with laparoscopic wedge resection of the lesion ＋ uterine scar repair to treatments cesarean scar pregnancy were retrospectively analyzed. Results Six patients were suc-cessfully operated with less bleeding and hysterectomy,minimally invasive,effective,quick recovery treatment. Conclusion Ce-sarean scar pregnancy underwent laparoscopic resection of local lesions of uterine repair can not only effectively terminate the preg-nancy,and can also repair scar defect and repair the uterus to retain reproductive function,so it is a very valuable method.