本文選題：子宮瘢痕妊娠　切入點(diǎn)：剖宮產(chǎn)　出處：《南昌大學(xué)》2017年碩士論文

【摘要】：剖宮產(chǎn)術(shù)后子宮瘢痕妊娠(cesarean scar pregnancy,CSP)是一種罕見的異位妊娠,其發(fā)病率近年呈上升趨勢(shì),診斷和治療技術(shù)也在不斷發(fā)展和改進(jìn)。診斷主要依靠經(jīng)陰道超聲、彩色多普勒三維成像等技術(shù)。CSP的早期診斷和選擇合適的治療方案對(duì)改善失血性休克、子宮切除等不良結(jié)局尤為重要。系統(tǒng)性使用甲氨蝶呤、刮宮術(shù)、子宮動(dòng)脈栓塞、經(jīng)腹或腹腔鏡下妊娠病灶切除修補(bǔ)術(shù)和宮腔鏡電切術(shù)是最常用的一線治療方法。研究證明,子宮動(dòng)脈栓塞術(shù)、經(jīng)腹或腹腔鏡下妊娠病灶切除修補(bǔ)術(shù)和宮腔鏡電切術(shù)治療風(fēng)險(xiǎn)低,成功率較高。系統(tǒng)性使用甲氨蝶呤、刮宮術(shù)治療風(fēng)險(xiǎn)高,成功率較低。最近有報(bào)道使用Foley導(dǎo)管進(jìn)行創(chuàng)新的微創(chuàng)治療。治療后再次懷孕是可行的,妊娠結(jié)局主要有正常宮內(nèi)妊娠、流產(chǎn)、再發(fā)CSP、不孕以及胎盤植入,應(yīng)被視為高危妊娠。
[Abstract]:Uterine scar pregnancy after cesarean section is a rare ectopic pregnancy. The incidence of Cesarean scar pregnancyn is increasing in recent years, and the diagnosis and treatment techniques are also developing and improving. The early diagnosis of CSP and the selection of appropriate treatment plan are particularly important to improve the adverse outcome of hemorrhagic shock, hysterectomy and other adverse outcomes, such as systemic use of methotrexate, uterine curettage, uterine artery embolism, and so on. Transabdominal or laparoscopic resection and repair of pregnancy foci and hysteroscopic resection are the most commonly used first-line treatments. Studies have shown that uterine artery embolization, transabdominal or laparoscopic resection and repair of pregnancy lesions and hysteroscopic resection are of low risk. The success rate is high. Systemic use of methotrexate, curettage treatment of high risk, low success rate. Recently reported use of Foley catheter for innovative minimally invasive treatment. Abortion, recurrent CSP, infertility, and placenta accreta should be considered high-risk pregnancy.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R714.22

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