宫腔镜手术治疗内生型剖宫产瘢痕妊娠34例临床分析

Hysteroscopic Surgery for Endogenous Cesarean Scar Pregnancy: Clinical Analysis of 34 Cases

目的探讨宫腔镜治疗内生型剖宫产瘢痕妊娠（cesarean scar pregnancy,CSP）的临床应用价值。方法 2012年4月～2014年10月,对34例内生型CSP采用宫腔镜手术治疗,其中7例行宫腔镜下清宫术,27例行子宫动脉栓塞后宫腔镜下清宫术,术后定期复查血β-h CG及B超。结果 34例CSP均1次手术成功。手术时间（17.5±3.5）min,术中出血量（17.5±7.5）ml,总住院时间4～5 d,均未出现严重并发症,术后28天内血β-h CG均下降至正常,2个月内月经复潮。结论宫腔镜手术治疗CSP具有可视性好,出血少,操作简单,成功率高,术后并发症少,住院时间短等优点,值得在临床上推广。

Objective To investigate the applicative value of hysteroscopic surgery in the treatment of endogenous cesarean scar pregnancy （CSP）. Methods A total of 34 patients with CSP in this hospital from April 2012 to October 2014 were treated by hysteroscopic surgery. Seven patients received uterine curettage under hysteroscopy and 27 patients got uterine artery embolization therapy before hysteroscopic surgery. All of them were regularly reviewed of β-hCG levels and ultrasound examinations. Results The surgical procedure was successfully completed in all the 34 cases. The operation time was （17.5 ± 3.5 ） rain, the intraoperative blood loss was （17.5 ± 7.5） ml, and the hospitalization stay was 4 -5 days. All of them had no serious complications. Their β-hCG levels were dropped to normal range within 28 days after operation, and all the patients had menstruation within 2 months after surgery. Conclusion Hysteroscopic surgery for CSP has advantages of good visibility, less bleeding, simple performance, high success rate, hess postoperative complications, and shorter hospitalization time, being worthy of clinical utilization.