经阴道子宫峡部剖宫产瘢痕部位妊娠物切除术的疗效

Transvaginal removal of cesarean scar pregnancy at isthmus uterine

目的探讨经阴道子宫峡部剖宫产瘢痕部位妊娠(CSP)物切除术的临床疗效。方法安徽医科大学附属省立医院2012年8月至2015年8月收治的CSP患者36例,停经时间为32~87 d。子宫峡部剖宫产切口处包块最大直径9~83 mm,均经阴道行CSP物切除术。结果 35例患者手术成功,1例因术中出血多,中转开腹行妊娠物切除术。手术成功患者术后无并发症,术后血β~h CG恢复正常时间为12~30 d,术后均无不规则阴道流血、月经过多或过少等并发症出现。结论经阴道子宫峡部CSP物切除术,可以完全切除妊娠物,并修补子宫峡部切口缺陷,CSP物切除术式安全、简单、微创,值得临床进一步推广。

Objective To evaluate the transvaginal removal of cesarean scar pregnancy （CSP） at the isthmus uterine. Methods This was a retrospective study on 36 patients with CSP enrolled from August 2012 to August 2015 in Anhui Provincial Hospital Affiliated to Anhui Medical University. In the patients the amenorrhea period ranged from 32 to 87 days, and the maximum diameter of the mass at the u-terine isthmus ranged from 17 to 42 mm by ultrasonography. Transvaginal removal of the lesion at the isthmus uterine was performed. Results The procedure was completed in 35 patients without causing complications. A conversion to open surgery was needed in 1 case because of uncontrolled hemorrhage. The level of serum p - hCG was recovered to a normal range inl2 to 30 days. No patients had abnormal menstrua-tion. Conclusion Transvaginal removal of CSP at the isthmus uterine is an effective, minimally invasiveand simple procedure with few com-plications.