早孕期剖宫产瘢痕妊娠的临床及病理特点分析

Clinical and pathological characteristics of cesarean scar pregnancy in early pregnancy

目的分析早孕期剖宫产瘢痕妊娠的临床及病理特点。方法选取2016年1月至2017年6月期间本院收治的74例早孕期瘢痕妊娠患者,运用MRI检查将患者分为外生型组(32例)和内生型组(42例),分析其临床特征及病理特点。结果多数早孕期剖宫产瘢痕妊娠患者伴有下腹隐痛、阴道不规则出血及腹腔内出血问题,少数患者无明显症状表现;但外生型病理变化发生率明显高于内生型,差异有统计学意义(P<0.05),且外生型患者停经时间、人绒毛膜促性腺激素(hCG)水平、出血量及住院时间与内生型相比差异有统计学意义(P<0.05),两组患者年龄、距上次剖宫产时间及妊娠包块比较差异均无统计学意义。结论剖宫产瘢痕妊娠患者有外生型和内生型两种不同临床分型,其临床及病理特点均有差异,医者可根据不同分型结合患者病情设计个性化医疗方案,以帮助其早日恢复健康身心。

Objective To analyze the clinical and pathological characteristics of scar pregnancy during cesarean section in early pregnancy.Methods 74 cases of scar pregnancy in early pregnancy were selected from January 2016 to June 2017. The patients were divided into exogenous group(32 cases) and endogenous group(42 cases) by MRI examination, and their clinical and pathological characteristics were analyzed. Results Most patients with cesarean scar pregnancy in early pregnancy had abdominal pain, irregular vaginal bleeding and intra-abdominal hemorrhage, and a few had no obvious symptoms. However, the incidence of exogenous pathological changes was significantly higher than that of endogenous type(P<0.05), and the time of menopause, the level of human chorionic gonadotropin(hCG), the amount of bleeding and hospitalization of exogenous type patients were significantly higher than those of endogenous type(P<0.05). There was significant difference in time and endogenous type(P<0.05). There was no significant difference in ages, time from the last cesarean section and pregnancy mass between the two groups. Conclusion There are two different clinical types of cesarean scar pregnancy, exogenous type and endogenous type. Their clinical and pathological characteristics are different. Doctors can design individualized medical scheme according to different types and patient’ s condition to help them recover their health as soon as possible.