宫腹腔镜联合治疗Ⅲ型或包块型剖宫产瘢痕部位妊娠五例分析

Combination of laparoscopy and hysteroscopy in resection of type Ⅲ or mass type caesarean scar pregnancy

回顾性分析2016年12月至2018年2月浙江省台州医院采用宫腹腔镜联合治疗的5例Ⅲ型或包块型剖宫产瘢痕部位妊娠(CSP)患者的临床资料。5例中,3例为CSPⅢ型,2例为包块型,均由经阴道超声检查确诊,5例患者均接受宫腹腔镜联合妊娠包块清除加子宫下段肌层修补缝合术,术中平均出血量80 ml(50~100 ml),5例患者术后均未出现并发症,痊愈出院。平均住院时间9.4 d(8~12 d)。术后血β-hCG下降到正常时间为22 d(14~30 d),术后22~39 d月经来潮。宫腹腔镜联合妊娠包块清除是治疗Ⅲ型或包块型CSP的有效方法。

From December 2016 to February 2018, 5 patients with type Ⅲ or mass type cesarean scar pregnancy (CSP) were treated in Zhejiang Taizhou Hospital. The clinical features, imaging findings and disease outcome were retrospectively analyzed. There were 3 cases of type Ⅲ and 2 cases of mass type, which were diagnosed by transvaginal ultrasound. The CSPs were resected with combination of laparoscopy and hysteroscopy, the average intraoperative blood loss was 80 ml (50-100 ml) and there were not postoperative complications. The average length of hospital stay was 9.4 days (8-12 d). Postoperative serum β-hCG returned to normal in average 22 days (14-30 d), and the menstruation recovered in 22-39 days after operation. The data indicates that resection of type Ⅲ or mass type caesarean scar pregnancy with a combination of laparoscopy and hysteroscopy is an effective treatment.