腹腔镜下切除剖宫产瘢痕妊娠病灶的临床分析

Clinical analysis of laparoscopic resection for cesarean scar pregnancy

摘要:

目的 探讨腹腔镜在治疗剖宫产后子宫瘢痕妊娠（CSP）病灶切除手术的临床实用价值。方法 回顾性分析该院2012年9月-2015年9月收治的CSP患者，经阴道彩超确诊为外生型CSP患者16例进行腹腔镜下瘢痕妊娠物切除+子宫修补术治疗，观察手术时间、术中出血量、术后血β-人绒毛膜促性腺激素（β-HCG）下降时间、月经恢复、住院天数及月经复潮情况。结果 16例手术均顺利完成，平均出血量80 ml，平均手术时间70 min，术后平均4周血β-HCG下降至正常水平，平均住院时间8 d，术后32～42 d恢复月经周期。结论 术前明确诊断和分型后，对于外生型CSP患者进行腹腔镜手术治疗是一种理想的治疗方法。

Abstract:

Objective To explore the clinical value of laparoscopic surgery in treatment of cesarean scar pregnancy. Methods A retrospective analysis was performed on 16 patients of exogenous CSP treated by laparoscopic resection in combination with uterus neoplasty from September 2012 to September 2015, which operation time, bleeding volume, postoperative blood β-HCG decreased with time, menstrual cycle, length of hospital stay and time of menstruation turn over was observed. Result 16 cases of surgery were successfully completed, which average amount of bleeding was 80 ml, average operation time was 70 min, average postoperative blood β-HCG decreased to normal level was 4 weeks, average hospital stay was 8 days and the menstruation recovery was 32～42 d after surgery. Conclusion After preoperative diagnosis and classification for exogenous CSP patients undergoing laparoscopic surgery is an ideal treatment.