本文選題：術(shù)后子宮瘢痕妊娠　切入點(diǎn)：刮宮術(shù)　出處：《東南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年04期 　論文類型：期刊論文

【摘要】：目的:探索剖宮產(chǎn)后子宮愈合情況和刮宮術(shù)出血量對(duì)瘢痕妊娠的影響,評(píng)估瘢痕形態(tài)是否適宜再妊娠。方法:選取2010年10月至2014年10月經(jīng)承德醫(yī)學(xué)院附屬醫(yī)院診斷的術(shù)后子宮瘢痕妊娠(CSP)患者61例,在超聲引導(dǎo)下行刮宮術(shù)治療,治療后半年進(jìn)行復(fù)查。根據(jù)患者刮宮術(shù)后2年內(nèi)懷孕成功情況分為成功組(A組)與失敗組(B組),對(duì)比分析兩組患者刮宮術(shù)中出血量、尿β人絨毛膜促性腺激素(β-H CG)恢復(fù)陰性時(shí)間、復(fù)查時(shí)瘢痕處肌層增厚與否、血流是否異常以及卵泡刺激素(FSH)水平和黃體生成素(LH)水平是否異常。結(jié)果:刮宮術(shù)時(shí)出血量對(duì)CSP患者術(shù)后2年內(nèi)懷孕具有一定的影響(P0.05),尿β-H CG恢復(fù)時(shí)間對(duì)CSP患者再妊娠成功與否影響不大(P0.05)。瘢痕肌層增厚及瘢痕處血流異常對(duì)CSP刮宮術(shù)后2年內(nèi)懷孕影響較大(P0.05),FSH水平和LH水平異常對(duì)CSP刮宮術(shù)后2年內(nèi)懷孕影響不大(P0.05)。結(jié)論:剖宮產(chǎn)時(shí)出血量大、瘢痕肌層增厚及瘢痕處血流異常對(duì)CSP患者再妊娠具有重要的影響,此類情況再妊娠時(shí)須密切關(guān)注妊娠情況。
[Abstract]:Objective: to explore the effect of uterine healing after cesarean section and the amount of bleeding in uterine curettage on scar pregnancy. Methods: from October 2010 to 2014, 61 patients with postoperative uterine scar pregnancy were treated with curettage under ultrasound guidance, which were diagnosed by the affiliated Hospital of Chengde Medical College from October 2010 to 2014. According to the successful pregnancy within 2 years after curettage, the patients were divided into two groups: successful group A (group A) and failure group group (group B). The blood loss during curettage was compared between the two groups. Urinary 尾 -human chorionic gonadotropin (尾 -H CGG) returned to negative time, and the thickness of muscle layer at scar was thickened or not at the time of reexamination. Results: blood loss during uterine curettage had a certain effect on pregnancy in CSP patients within 2 years after operation (P 0.05). The recovery time of urinary 尾 -H-CG had a certain effect on CSP patients. The effect of scar muscle layer thickening and blood flow abnormality on pregnancy in 2 years after CSP curettage is not significant. Conclusion: the effect of CSP curettage on pregnancy within 2 years after CSP curettage is not significant. The amount of blood lost during the birth of the palace is large. The thickening of scar muscular layer and the abnormal blood flow in scar have important influence on the re-pregnancy of CSP patients, and it is necessary to pay close attention to the condition of pregnancy.
【作者單位】： 承德醫(yī)學(xué)院附屬醫(yī)院超聲科;承德市第三醫(yī)院放射科;
【基金】：河北省科技支撐計(jì)劃項(xiàng)目(20122177)
【分類號(hào)】：R445.1;R714.22

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