【摘要】 目的探讨剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)的手术方法及选择。方法回顾性分析2010年1月~2015年1月我院经阴道彩超检查符合CSP诊断标准的71例患者资料。内生型45例,均行宫腔镜治疗;外生型26例,宫腔镜治疗15例,腹腔镜治疗11例。结果内生型45例中宫腔镜手术成功率92%(41/45);外生型26例中宫腔镜手术成功率80%(12/15),腹腔镜手术成功率82%(9/11)。结论 CSP患者术前分型对于选择治疗方法有一定的意义,内生型首选宫腔镜手术,外生型宫腔镜和腹腔镜均能治疗,但这两种微创手术仍有一定局限性,经腹和经阴道手术有时仍是必不可少的方法。更多还原

【Abstract】 Objective To discuss the selection of different operation methods for cesarean scar pregnancy( CSP).Methods A retrospective analysis was made on clinical data of 71 CSP patients treated in our hospital from January 2010 to January2015. All the patients were accurately diagnosed by transvaginal color ultrasound examinations. Hysteroscopic evacuation was performed in 45 endogenous CSP patients,while in 26 exogenous CSP patients,15 of them were treated by hysteroscopy and the other11 patients were given laparoscopic operation. Results For the 45 endogenous patients,the success rate of hysteroscopic therapy was 92%( 41 /45). For the 26 exogenous patients,the success rate was 80%( 12 /15) for hysteroscopic and 82%( 9 /11) for laparoscopic therapy. Conclusions Preoperative categorizing of CSP is important for choosing different surgery methods.Hysteroscopic evacuation is the first choice for endogenous CSP. For exogenous patients,both hysteroscopic evacuation and laparotomy can be chosen. Therefore,the two minimally invasive procedures have limits,and transvaginal and laparotomy resection of lesion is still necessary sometimes.更多还原