B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗剖宫产切口妊娠临床分析.docVIP

精品论文 参考文献 B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗剖宫产切口妊娠临床分析 李晓丹 （温州市人民医院妇产科 325000） 【摘要】目的 探讨B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗剖宫产切口妊娠安全性、可行性及临床价值。方法　回顾性分析2009年1月-2011年1月本科对剖宫产切口妊娠20例行B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗的疗效。结果　20例患者中20例予B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗后再辅助超声监护下刮宫，95%(19/20)孕妇治疗成功，19例患者全部治疗成功，出血少，1例系葡萄胎剖宫产切口妊娠,行经腹瘢痕剔除，（术后B-HCG下降明显，平均27.10plusmn;6.51天后降至正常水平）。结论　B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗剖宫产切口妊娠再联合超声监护下刮宫或手术治疗是可选择的安全有效的治疗方法。 【关键词】 剖宫产 切口妊娠 甲氨蝶呤 【中图分类号】R714.22 【文献标识码】A 【文章编号】2095-1752（2013）19-0021-02 Clinical analysis of the treatment of cesarean section pregnancy through intracapsular injection of MTX under B ultrasound and aspiration of cyst fluid Xiaodan Li (Obstetrics and Gynecology, Peoples Hospital of Wenzhou City, Zhejiang 325000) 【Abstract】 Objective: the safety, feasibility and clinical value of the treatment of cesarean section pregnancy through intracapsular injection of MTX under B ultrasound. Methods: intracapsular injection of MTX under B-ultrasound for 20patients of cesarean section pregnancy from 2009 January to 2011 January in our hospital.Results: 20 patients are treated by intracapsular injection of MTX under B-ultrasound and aspiration of cyst fluid and then curettage under the supervision of ultrasound. The therapy of 19 patients is successful with less bleeding, and 1 patient is mole production incision pregnancy removed by surgery through abdominal scar.Conclusion: It is the alternative safe and effective treatment method of cesarean section pregnancy by intracapsular injection of MTX under B ultrasound and suction capsule liquid combined with curettage under the supervision of ultrasound or surgery. 【Key words】 cesarean section pregnancy methotrexate 剖宫产切口妊娠是指妊娠囊或者胚囊着床在既往剖宫产切口瘢痕处，是???位妊娠最罕见的一种[1],如若未及时处理，可引起子宫破裂和阴道大出血的风险,严重时可危及患者生命,随着剖宫产的增加，剖宫产术后剖宫产切口妊娠的发生率明显增加。近年来，本院采用B超下囊液抽吸及孕囊内注射甲氨蝶呤治疗剖宫产切口妊娠20例，效果确切。 1 资料与方法 1.1 一般资料 本组剖官产切口妊娠患者20例，年龄25～48岁，（34.90plusmn;5.37）岁，孕次1-6次，（3.25plusmn;1.12）次，既往剖宫产次数为1-