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[1]杨斌,肖梅,陈赛英,等.子宫瘢痕妊娠的影像学特征及临床治疗[J].医学研究与战创伤救治(原医学研究生学报),2017,19(06):595-599.[doi:10.3969/j.issn.1672-271X.2017.06.009]
　YANG Bin,XIAO Mei,CHEN Sai-ying,et al.Imaging features and clinical treatment options of cesarean scar pregnancy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(06):595-599.[doi:10.3969/j.issn.1672-271X.2017.06.009]
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子宫瘢痕妊娠的影像学特征及临床治疗()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年06期
页码:
595-599
栏目:
出版日期:
2017-11-23

文章信息/Info

Title:
Imaging features and clinical treatment options of cesarean scar pregnancy
作者:
杨斌1; 肖梅1; 陈赛英1; 丁蓉蓉2
作者单位：210002南京，解放军第81医院，1.妇产科，2.门诊部
Author(s):
YANG Bin1; XIAO Mei1; CHEN Sai-ying1; DING Rong-rong2
(1.Department of Gynecology and Obstetrics，2. Department of Outpatient, the 81th Hospital of PLA, Nanjing 210002,Jiangsu,China)
关键词:
子宫瘢痕妊娠; 治疗; 阴道彩超; 磁共振
Keywords:
Cesarean scar pregnancy;  Treatment;  Transvaginal color Doppler ultrasound;  Magnetic Resonance Imaging
分类号:
R711.74
DOI:
10.3969/j.issn.1672-271X.2017.06.009
文献标志码:
A
摘要:
目的分析子宫瘢痕妊娠的影像学特征及不同治疗方法和疗效。方法收集解放军第81医院2012-2015年收治的子宫瘢痕妊娠56例患者，分析其超声和磁共振图像特点、临床表现及不同治疗方法的疗效。56例患者全部完成阴道彩超及磁共振检查。结果56例中阴道彩超正确诊断50例，准确率89.2%，磁共振全部正确诊断，准确率100%。其中50例患者行甲氨喋呤联合米非司酮治疗、子宫动脉栓塞联合甲氨蝶呤后行清宫术治疗、超声引导下清宫术；1例经子宫动脉栓塞后给予清宫术，术后7d阴道大量出血，再次急诊开腹子宫局部病灶切除治疗；5例行开腹子宫病灶切除术。无一例行子宫切除术，所有患者均痊愈出院。结论早期影像学诊断对于子宫瘢痕妊娠诊断至关重要，超声检查是主要的诊断方法，磁共振更加准确，可以作为超声诊断疑难时的有效补充。明确诊断后，需要尽早选择合适的治疗方案，避免严重的并发症及子宫切除的风险。
Abstract:
ObjectiveImaging features and different treatment methods and therapeutic effects of Cesarean scar pregnancy (CSP) will be discussed.MethodsIn the 81th hospital of the PLA from 2012-2015, the clinical data of 56 patients with CSP were included into this study. The imaging features and treatment outcomes of these pregnancies were recorded. All of them were undergone transvaginal color Doppler ultrasound and magnetic resonance imaging (MRI) examination.ResultsAmong these patients, 50 cases were correctly diagnosed by transvaginal color Doppler ultrasound, diagnostic accuracy was 89.2%, 56 cases were correctly diagnosed by MRI, diagnostic accuracy was 100%. 50 cases underwent successful termination by curettage with ultrasonic guidance, mifepristone combined methotrexate, a combination of uterine artery embolization and methotrexate and curettage. Five patients were cured by transabdominal excision of uterus lesion. One patient underwent curettage after the uterine artery embolization, but heavy vaginal bleeding occurred seven days later after the curettage. At last, she was cured by emergency excision of uterus lesion and part uterine horns. In this study, no patients had uterus resection.ConclusionEarly imaging recognition is critically important for CSP. Ultrasound is the main diagnostic choice. MRI can be used as an effective supplement for the diagnosis of ultrasound. The appropriate treatment should be taken as early as possible to minimize maternal complications and preserve future fertility.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2017-11-20