| 摘要: |
| 目的 探讨高强度聚焦超声治疗剖宫产瘢痕妊娠的临床价值。方法 2015年6月～2016年4月对15例确诊为剖宫产瘢痕部位妊娠患者给予高强度聚焦超声治疗,术后针对病灶突向宫腔者行宫腔镜电切术或B超监测下清宫术。观察手术时间、病灶血供变化、血β-hCG下降情况、月经复潮等指标。结果 15例患者均一次性完成治疗,手术时间15min～97min(平均52.9min)。术后超声造影对比术前均提示病灶及其周边血流信号明显减少且复查血β-HCG均呈不同程度下降。其中7例于高强度聚焦超声治疗后行宫腔镜妊娠病灶电切术,术中失血2～50ml(平均15ml)；1例行B超监测下清宫术,失血10ml,均一次性成功清除胚胎组织,血β-hCG恢复正常时间(23.9±6.1)天,月经恢复时间为(31.4±4.7)天。其余7例因病灶突向浆膜层而未行清宫术,血β-hCG恢复正常时间为(31.8±7.5)天,月经恢复时间为(43.9±10.4)天。15例患者术后随访3个月,均无其他并发症发生。结论 高强度聚焦超声治疗剖宫产瘢痕部位妊娠安全有效且微创。 |
| 关键词: 高强度聚焦超声 剖宫产瘢痕部位妊娠 宫腔镜 |
| DOI： |
| 投稿时间：2016-12-11修订日期：2018-03-18 |
| 基金项目: |
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| The clinical analysis of the high－intensity focused ultrasound therapy for the cesarean scar pregnancy(CSP)Wang Zhenjun,Jiang Jing,Zeng Yuhua,Zhou Honggui* |
| wangzhenjun,zhouhonggui |
| () |
| Abstract: |
| Objective To investigate the clinical value of the high－intensity focused ultrasound therapy for the CSP.Methods June 2015 ~ April 2016, 15 cases of diagnosed as cesarean scar pregnancy(CSP) were given the high- intensity focused ultrasound treatment. And after the therapy, the hysteroscopy electrotomy or the curettage were given for the patients, with the lesion in the uterine cavity.The operation time, blood flow of the lesion, decline of the serum β-hCG and menstruation recovery were retrospectively analyzed. Results All the patients received 1 session of HIFU ablation therapy. The operation time ranged from 15 to 97 min(mean,52.9min).After the treatment,contrast-enhanced ultrasound of these 15 patients showed, the lesion and the surrounding blood flow was significantly reduced, and the review of serum β-hCG showed different degrees of decline. 7 cases underwent the hysteroscopy electrotomy ,the intraoperative blood loss was 2～50ml(mean,15ml), and 1 case underwent the curettage under the monitoring of b-ultrasonic, the intraoperative blood loss was 10ml. All of them were successfully cleared embryonic tissue. The average time needed for serum β-hCG to return to normal levels was (23.9±6.1)days.The average time for menstruation recovery was (31.4±4.7)days.The rest of the 7 cases were without curettage, due to lesions in serous layer. The average time needed for serum β-hCG to return to normal levels was (31.8±7.5)days.The average time for menstruation recovery was (43.9±10.4)days.15 patients were followed up for 3 months, no other complications.Conclusion High－intensity focused ultrasound is a safe, effective and minimally invasive method for the treatment of CSP. |
| Key words: High－intensity focused ultrasound Cesarean scar pregnancy Hysteroscopy |
