ObjectiveTo explore the nursing method for patients with urerine incision pregnancy. MethodsBetween July 2012 and April 2013, 82 patients with uterine incision pregnancy were selected, including 6 with massive haemorrhage after dilatation and evacuation in other hospitals before received in our department. All of the patients underwent arterial chemotherapy infusion and embolization; dilatation and evacuation was performed under the monitoring of B-scan ultrasound; and the patients received intensive care. ResultsAll of the 82 patients with uterine incision pregnancy were cured via proper treatment and care. ConclusionUterine artery embolization is an effective treatment method for pregnancy incision, which has advantages like minimally invasion, quick effect, and uterus preservation. Strengthen psychological care and close observation of the disease, as well as health guidance are important for the success of incision pregnancy treatment.
【摘要】 目的 探討雙側子宮動脈化療栓塞術治療剖宮產子宮切口妊娠的臨床應用價值。 方法 2004年3月-2009年10月確診剖宮產子宮切口妊娠的患者25例。首先行雙側子宮動脈超選擇插管，注入甲氨喋嶺，再用明膠海綿條栓塞雙側子宮動脈，48~72 h內在B型超聲監測下行清宮術。 結果 25例子宮動脈化療栓塞術后復查B型超聲，提示孕囊血供明顯減少。22例在B型超聲監測下一次性清除胚胎組織，出血量少；2例因胚胎植入肌層突向漿膜層栓塞術后加用氟尿嘧啶，未行清宮，自行排出；1例因術后切口處形成大血腫行手術治療。 結論 雙側子宮動脈化療栓塞術是治療剖宮產子宮切口妊娠一種有效方法，既保留子宮，又保留其生育功能。【Abstract】 Objective To evaluate the application of bilateral uterine artery chemoembolization for caesarean scar pregnancy (CSP）. Methods A total of 25 patients with CSP From March 2004 to October 2009 were selected. Bilateral uterine artery super selective catheterization was performed after injection with methotrexate, and gelatin sponge granules were injected into blateral uterine artery. Then atificial abortion was performed under B-ultrasonic scanning within 48-72 hours. Results In all 25 cases, the blood flow of the embryo decreased significantly after uterine artery chemoembolization. A total of 22 patients received artificial abortion successfully with little vaginal bleeding;two pateints received medication with 5-FU duet to the embryo near to the perimetrium, and finally the embryo expulsed spontaneously;one patient underwent hysterectomy, because a huge hematoma was formed at the incision of the uterus after uterine artery chemoembolization. Conclusion Bilateral uterine artery chemoembolization is effective for CSP, which could keep the uterus and the patients’ reproductive function.
【摘要】 目的 探討子宮部位異位妊娠的臨床特征和處理對策。 方法 回顧分析2002年9月-2009年9月間收治的31例子宮部位異位妊娠患者的臨床資料。 結果 31例患者中，初診確診僅8例，誤診率74.2%。除5例因難以控制的大出血行經腹病灶清除術加子宮修補術或全子宮切除術外，其余26例患者均經氨甲喋呤（MTX）治療加清宮術或宮腔鏡下病灶清除術保守治療成功。 結論 子宮部位異位妊娠容易誤診，超聲檢查是診斷的主要方法。保守治療安全、有效，可保留生育能力。氨甲喋呤治療加清宮術可作為治療子宮部位異位妊娠的主要方法。【Abstract】 Objective To investigate the clinical characteristics and treatment of ectopic pregnancy in the uterus. Methods The clinical data of 31 patients diagnosed as ectopic pregnancy from September 2002 to September 2009 were analyzed retrospectively. Results During preliminary diagnosis, only eight patients were accurately diagnosed.The error rate of first diagnosis was 74.2%. Five patients suffered focal cleaning and uterus neoplasty or total hysterectomy due to uncontrollable bleeding.The other 26 patients were successfully cured by conservation treatment of methotrexate (MTX) combined with dilatation and curettage or clearance of focal lesion under hysteroscopy. Conclusion Misdiagnosis of ectopic pregnancy in the uterus is easy to make.The ultrasonography is the main method for the diagnosis of ectopic pregnancy in the uterus.Conservative treatment is proved to be safe and effective and can preserve the patients’ fertility. Administration of MTX combined with dilatation and curettage is an main therapeutic method in handling ectopic pregnancy in the uterus.
ObjectiveTo investigate the value of uterine compression suture through laparoscopy in the treatment of cesarean scar pregnancy (CSP). MethodsA random controlled study was conducted on 85 CSP patients diagnosed between September 2013 and December 2014. The patients were randomly divided into control group (n=43) and study group (n=42). The control group received routine evacuation under laparoscopy, while the study group received routine evaluation under laparoscopy combined with uterine compression suture. The efficacy of the two treatments were compared and analyzed. ResultsThe operation time of the control group and the study group was (36.6±17.7) and (45.6±14.8) minutes, respectively. Total amount of bleeding during and after the operation was (207.9±165.8) and (96.1±29.0) mL for the two groups of patients, and the above differences were statistically significant (P＜0.05). There was no significant difference in the indicators of anal exhaust time, hospitalization stay, blood β-human chorionic gonadotrophin clearance time, and menstruation recovery time between the two groups (P>0.05). ConclusionUterine compression suture through laparoscopy is a safe and reliable method to reduce the bleeding of CSP, which is easy to perform and worthy of promotion.
目的 探討急診行子宮動脈灌注藥物栓塞術治療剖宮產后切口妊娠的可行性和臨床價值。 方法 2009年10月－2011年12月，對17例臨床證實切口瘢痕妊娠并陰道出血患者，急診行雙側子宮動脈灌注甲氨蝶呤并超選擇栓塞術，術后通過觀察人絨毛膜促性腺激素（HCG）水平、陰道出血及術后清宮術來評價療效。 結果 17例患者急診行子宮動脈灌注栓塞術成功，術后陰道出血均停止或減少，HCG水平均明顯下降，3例因孕囊自行排除而未行清宮，14例術后2～4 d行胚胎鉗刮術，術中出血量較少。所有患者1周后均治愈出院。 結論 子宮動脈灌注栓塞術是治療剖宮產術后切口瘢痕妊娠的一種有效方法，可及時治療陰道大出血，促進殺胚，并為術后清宮提供安全保障。
目的 探討子宮動脈化療栓塞在剖宮產術后子宮切口妊娠治療中的可行性和安全性。 方法 回顧分析2006年7月－2011年3月收治的152例剖宮產切口瘢痕妊娠行介入治療的病例資料。 結果 152例子宮動脈化療栓塞操作均成功。陰道大出血或不規則出血均得到有效控制。人絨毛膜促性腺激素β亞型較術前下降，差異有統計學意義（Z=?9.295，P=0.000），術后2～22 d行清宮術，術中失血3～100 mL，平均27 mL。3例行子宮切除術，子宮切除率2%。1例發生栓子脫落導致左下肢脛前動脈栓塞并發癥。 結論 子宮動脈化療栓塞治療剖宮產術后切口妊娠可有效控制大出血、降低清宮風險、降低子宮切除風險，是治療切口妊娠的有效可行方法之一。