【摘要】 目的:探讨腹腔镜下不同手术方式应用于不同临床分型的剖宫产瘢痕妊娠(CSP)手术治疗的有效性和安全性。方法:回顾性分析2006~2012年行腹腔镜下手术治疗的36例CSP患者的临床资料,根据手术方式的不同类型分别探讨CSP不同临床分型的手术情况及术后恢复情况。结果:行腹腔镜监视下清宫术13例,其中CSP临床分型为Ⅰ型11例,Ⅱ型2例;腹腔镜下双侧子宫动脉阻断+清宫术12例,其中Ⅰ型3例,Ⅱ型9例;腹腔镜下双侧子宫动脉阻断+腹腔镜下瘢痕妊娠病灶清除术+子宫修补术10例,均为Ⅲ型患者;腹腔镜下全子宫切除术1例,为Ⅲ型患者。36例患者手术均成功,无中转开腹,无术中及术后并发症。术后患者均恢复良好,术后随访血β-HCG降为正常的时间为术后2~4周,术后4~6周月经恢复来潮。结论:根据CSP不同的临床分型合理采取不同的腹腔镜手术方式,不仅能达到治愈目的,而且能有效地保留患者的生育功能。更多还原

【Abstract】 Objective: To explore the effectiveness and safety of laparoscopic surgical approaches for different clinical types of caesarean scar pregnancy( CSP) 。Methods: The clinical data of 36 cases experiencing laparoscopic surgery for CSP from 2006 to 2012 were retrospective analyzed. According to the different types of operation methods,the surgical conditions and postoperative recovery in the different clinical types of CSP were compared. Results: Curettage under laparoscopic monitoring in 13 cases,including CSP clinical classification as Ⅰ type 11 cases,Ⅱ type 2 cases. Curettage combined with Laparoscopic bilateral uterine artery occlusion in 12 cases,including Ⅰ-type 3 cases,Ⅱ type 9 cases; Laparoscopic bilateral uterine artery occlusion combined with scar pregnancy debridement and uterine repair surgery in 10 cases which were all type Ⅲ; laparoscopic hysterectomy one case,type Ⅲ patients. Laparoscopic surgical was fulfilled in 36 cases patients and without laparotomy and surgical complications. All patients recovered uneventfully,after the operation,blood hCG returned to normal in 2-4 weeks,menstrual recovery in 4-6 weeks. Conclusions: According to CSP different clinical types,taking a different laparoscopic surgery method not only can achieve the purpose of cure,but also can effectively retain the patient’s reproductive function.更多还原