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目的探讨宫腔镜电切术在治疗剖宫产术后切口处妊娠(CSP)中的临床治疗及应用。方法通过回顾性分析我院2008年1月至2013年1月收治的31例剖宫产术后切口处妊娠患者在B超监视下进行宫腔镜电切术治疗,术毕给予甲氨蝶呤宫颈注射,术后复查血β-HCG值及盆腔超声检查。结果 31例患者中除有2例因术中出血过多,急诊开腹手术行病灶切除术外,其余29例均1次手术成功,无大出血、子宫穿孔发生。手术时间(30.7±6.8)min,出血量为(50.6±36.5)mL。术后3d血β-HCG下降(80.3%±10.4%),术后血β-hCG(25±10)d降至正常,术后病理检查与CSP诊断相符合。结论在严格把握适应症的情况下,宫腔镜下病灶电切术是治疗CSP的有效治疗方法。
Objective To investigate the clinical treatment and application of hysteroscopic electrotomy in the treatment of incision cesarean section pregnancy (CSP). Methods By retrospective analysis of 31 cases of cesarean section incision in our hospital from January 2008 to January 2013 were treated by hysteroscopic resection under ultrasound B ultrasound, Cervical injection, postoperative blood β-HCG and pelvic ultrasound examination. Results Except for 2 cases in 31 patients, all the other 29 cases were successfully operated by one operation due to excessive intraoperative hemorrhage and emergency laparotomy. There was no major bleeding and uterine perforation occurred. The operation time (30.7 ± 6.8) min, bleeding volume (50.6 ± 36.5) mL. The postoperative β-HCG decreased (80.3% ± 10.4%) and the postoperative β-hCG (25 ± 10) d decreased to normal postoperative pathological examination consistent with the diagnosis of CSP. Conclusion In the strict indications, hysteroscopic resection of the lesion is an effective treatment for CSP.