子宫瘢痕妊娠化疗药物无刨孕囊内注射杀胚法的临床分析

Clinical analysis of uterine scar pregnancy chemotherapeutic drug without planing, intrafollicular injection and blastocyst injection

目的通过分析刨宫产术后子宫瘢痕妊娠(CSP)患者病例资料,研究治疗刨宫产瘢痕妊娠的手术方法和疗效。方法回顾性分析我院2016年8月~2017年5月收治的14例瘢痕妊娠和2例稽留流产患者诊治临床资料。结果本研究中4组患者均为行开腹手术,手术均基本顺利。B超和宫腔镜检测,"米非司酮+(MTX+NS)孕囊注射+B超+宫腔镜+清宫术"组均可见孕囊变形及位置下移,对患者无任何身体上的损伤,与传统方法则极少见。结论在"米非司酮+(MTX+NS)孕囊注射+B超+宫腔镜+清宫术"的引导下的微创手术均是CSP的有效治疗方法。其明显减少出血量,减少宫腔操作时间,降低宫腔感染机会。

Objective To analyze the operative method and curative effect of cesarean scar pregnancy by analyzing the data of patients with uterine scar pregnancy（CSP） after caesarean section. Methods Retrospective analysis of 14 cases of scar pregnancy in our hospital from August 2016 to May 2017 and the diagnosis and treatment of 2 cases of patients with missed abortion clinical data. Results In this study, 4 groups of patients were all operated on open surgery, and the operation was basically smooth. B ultrasound and hysteroscopy showed that the gestational sac deformability and location were all down in the Group [mifepristone ＋（MTX＋NS） gestational sac injection ＋ B ultrasound ＋ hysteroscopy ＋ curettage operation]. There was no physical damage to the patients, and it was very rare with traditional methods. Conclusion The minimally invasive surgery guided by the injection of mifepristone ＋（MTX＋NS） and B-ultrasound ＋ hysteroscopy plus the hysteroscopy is an effective method for the treatment of CSP. It obviously reduces the amount of bleeding, reduces the time of uterine cavity operation, and reduces the opportunity of uterine cavity infection.