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

目的研究早孕期剖宫产瘢痕妊娠的临床病理特点。方法回顾性分析42例早孕期剖宫产瘢痕妊娠患者的临床资料,对患者病理特点进行研究。结果 24例患者在B超监视下进行宫腔镜病灶电切术治疗, 10例患者因为子宫肌层较为薄弱,采用腹腔镜病灶楔形切除手术进行治疗, 8例患者采用药物进行保守治疗。手术治疗患者的人绒毛膜促性腺激素(β-HCG)水平降至正常时间和住院时间分别为(13.3±3.5)、(5.3±1.1)d,均短于保守治疗患者的(34.2±5.4)、(8.5±1.8)d,差异均有统计学意义(P<0.05)。结论早孕期剖宫产瘢痕妊娠的患者采用磁共振进行早期检验可有效对患者作出分型,同时为患者进行病理学检验,能够对疾病进行准确的鉴定。对于早孕期剖宫产瘢痕妊娠患者在治疗时,需要坚持及早发现及早治疗的原则,如果患者的身体状况允许,以腹腔镜手术方案进行治疗所取得的效果明显优于常规药物治疗,在满足各项条件的前提下,为患者及早选择腹腔镜手术方案治疗。

Objective To study the clinical and pathological characteristics of cesarean scar pregnancy in early pregnancy. Methods The clinical data of 42 cases of cesarean scar pregnancy in early pregnancy was retrospectively analyzed, and their pathological characteristics was studied. Results 24 patients were treated by hysteroscopic focus electrotomy under B-ultrasonic monitoring, 10 patients were treated by laparoscopic wedge resection because of the weakness of the myometrium, and 8 patients were treated conservatively with drugs. Time for human chorionic gonadotropin(β-HCG) returning normal and hospitalization time were(13.3±3.5)and(5.3±1.1) d in surgical treatment patients, which were shorter than(34.2±5.4) and(8.5±1.8) d in conservative treatment patients, and their difference was statistically significant(P<0.05). Conclusion Early magnetic resonance imaging can effectively classify the patients with cesarean scar pregnancy in early pregnancy, and pathological examination can accurately identify the disease. For patients with cesarean scar pregnancy in early pregnancy, we need to adhere to the principle of early detection and early treatment. If the patient’s physical condition permits, the effect of laparoscopic surgery is significantly better than that of routine drug treatment. On the premise of satisfying all conditions, we should choose laparoscopic surgery as early as possible.