摘要
目的分析经阴道手术治疗剖宫产瘢痕妊娠失败的原因,以期提高手术治疗的成功率。方法回顾性分析我院经阴道微创手术治疗32例剖宫产瘢痕妊娠患者临床资料,重点分析4例失败原因。结果 32例经阴道手术患者,顺利完成CSP病灶切除28例(87.5%)。有4例患者阴道手术失败而中转开腹手术,均距前次剖宫产术5年以上,宫颈过长致病灶位置过高、病灶周围组织致密粘连、解剖层次不清、病灶周围血供丰富是导致手术失败的主要原因。结论在剖宫产瘢痕妊娠的诊治过程中,超声联合核磁共振进行充分的术前评估,对选择适宜的手术方式非常重要。
Objective To improve the success rate of surgical treatment by analyzing the causes of the failure of transvaginal surgery in the treatment of cesarean scar pregnancy（ CSP）. Method The clinical data of 32 CSP cases treated by transvaginal minimally invasive surgery were analyzed retrospectively in our hospital,and were focused on the failure factors in 4 CSP cases. Results A total of 28 cases were ablated the CSP focus by transvaginal hysterotomy,but 4 cases failed. The main factors of the failure were excessive cervical lesions,dense adhesions around the lesion,unsharp anatomical level and abundant blood supply around the lesion. Conclusion The adequate preoperative evaluation of ultrasonography combined with MRI can play an important role in selection of appropriate surgical method for the diagnosis and treatment of CSP.
作者
魏华
王晓雯
凌晟荣
陈克明
易村犍
WEI Hua WANG Xiao-wen LING Sheng-rong CHEN Ke-ming YI Cun-jian(Department of Obstetrics and Gynecology, The First Clinical Medicine College of Yangtze University, Jingzhou 434000, Hubei, China Department of Obstetrics and Gynecology, The First Affiliated Hospital of Yangtze University / Jingzhou First People~ Hospital, Jingzhou 434000, Hubei, China)
出处
《中国现代手术学杂志》
2016年第5期382-385,共4页
Chinese Journal of Modern Operative Surgery
基金
湖北省医学领军人才培养工程专项经费资助(鄂卫生计生发(2013)4号)
关键词
剖宫产瘢痕妊娠
经阴道手术
超声检查
磁共振成像
cesarean scar pregnancy
transvaginal operation
ultrasonography
magnetic resonance imaging
