[1]陈燕,蒋静*.高强度聚焦超声联合宫腔镜治疗剖宫产瘢痕妊娠22例分析[J].中国计划生育和妇产科,2019,(5):33-３５,４１.
　CHEN Yan,JIANG Jing*.High-intensity focused ultrasound combined with hysteroscope for the treatment of 22 cases of cesarean scar pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2019,(5):33-３５,４１.
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高强度聚焦超声联合宫腔镜治疗剖宫产瘢痕妊娠22例分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年5期
页码:
33-３５,４１
栏目:
论著与临床
出版日期:
2019-05-25

文章信息/Info

Title:
High-intensity focused ultrasound combined with hysteroscope for the treatment of 22 cases of cesarean scar pregnancy
作者:
陈燕; 蒋静*
川北医学院附属医院妇产科
Author(s):
CHEN Yan; JIANG Jing*
Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan 637000, P.R.China
关键词:
高强度聚焦超声; 宫腔镜; 剖宫产瘢痕妊娠; 磁共振
Keywords:
high-intensity focused ultrasound;  hysteroscope; cesarean scar pregnancy;  magnetic resonance imaging
分类号:
R 4541
摘要:
目的探讨高强度聚焦超声（high-intensity focused ultrasound，HIFU）联合宫腔镜治疗剖宫产瘢痕妊娠(cesarean scar pregnancy，CSP)的有效性及安全性。方法回顾性分析2017年在川北医学院附属医院经阴道彩超或磁共振确诊的22例CSP患者的临床资料，22例患者均行1次HIFU治疗，HIFU治疗1～5 d后在宫腔镜下行妊娠病灶清除术，观察治疗后血β-人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）变化情况、清宫术中出血量及月经恢复正常时间。结果22例患者均顺利完成1次HIFU治疗，治疗时间平均（412±92）min，辐照时间平均（4090±1163）s，治疗强度平均（5950±1149） s/h，无严重并发症发生。行宫腔镜病灶清除术，术中平均出血量100 mL（3～1 200 mL），其中2例患者术中出血多，分别为500 mL和1 200 mL，给予Foleys尿管压迫止血，输入红细胞悬液。宫腔镜术后（294±137）d hCG降为正常，（410±150）d恢复正常月经。结论HIFU联合宫腔镜治疗CSP有较好的安全性和有效性，但尚需更多的研究明确其确切适用范围。
Abstract:
ObjectiveTo evaluate the feasibility and safety of high-intensity focused ultrasound (HIFU) treatment combined with hysteroscope for the treatment of cesarean scar pregnancy (CSP).MethodsRetrospective analysis of 22 cases of CSP diagnosed by vaginal color Doppler ultrasound or MRI at the Affiliated Hospital of North Sichuan Medical College from January to December 2017，all the patients received HIFU ablation, suction curettage under hysteroscopic guidance was performed at 1~5 days after HIFU ablation. The change of β-human chorionic gonadotropin (β-hCG) level，intraoperative blood loss in suction curettage and time for normal menstruation recovery were recorded. ResultsAll the 22 patients successfully completed once HIFU treatment, the average treatment time was (412±92) min; the irradiation time was average (4090±1163) s; the treatment intensity was (5950±1149) s/h, no serious complications occurred.During hysteroscopic curettage,the average intraoperative blood loss was 100 mL (3~1 200 mL). Two of the patients had more intraoperative hemorrhage, 500 mL and 1 200 mL, respectively. The Foleys urinary catheter was used to stop bleeding and the red blood cell suspension was input. After hysteroscopic surgery (294 ± 137) d hCG decreased to normal, (410 ± 150) d returned to normal menstruation. ConclusionHIFU combined with hysteroscopic treatment of CSP has good safety and effectiveness, but more research is needed to clarify its exact scope of application.

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备注/Memo

备注/Memo:
四川省医学会基金项目（项目编号：S17029 ）
更新日期/Last Update: 2019-05-25