城口县妇幼保健院成功救治剖宫产瘢痕妊娠1例
<p style="text-indent:21px"><span style=";font-family:宋体;font-size:14px"> <span style="font-family:宋体">剖宫产术后子宫瘢痕妊娠（</span><span style="font-family:Calibri">Cesarean scar pregnancy, CSP</span><span style="font-family:宋体">）是胚胎种植于剖宫产瘢痕处妊娠，是一种诊断困难、让医生处理棘手的特殊类型的异位妊娠。如延误诊断，处理不当，则可以导致大出血、子宫破裂、全子宫切除甚至危及生命等严重后果。目前我国是全球剖宫产率最高的国家，而且随着生育政策的调整，</span><span style="font-family:Calibri">CSP</span><span style="font-family:宋体">也呈增多趋势。</span></span></p><p style="text-indent:21px"></p><p style="text-indent:28px"><span style=";font-family:宋体;font-size:14px"><span style="font-family:宋体">患者吴某某，女，</span><span style="font-family:Calibri">37</span><span style="font-family:宋体">岁，因“停经</span><span style="font-family:Calibri">2+</span><span style="font-family:宋体">月，药流失败</span><span style="font-family:Calibri">20+</span><span style="font-family:宋体">天”于</span><span style="font-family:Calibri">2022.10.31</span><span style="font-family:宋体">入我院妇科。入院诊断：</span><span style="font-family:Calibri">1.</span><span style="font-family:宋体">药物流产失败：妊娠状态（妊娠</span><span style="font-family:Calibri">9+5</span><span style="font-family:宋体">周 孕</span><span style="font-family:Calibri">5</span><span style="font-family:宋体">产</span><span style="font-family:Calibri">2</span><span style="font-family:宋体">） </span><span style="font-family:Calibri">2.</span><span style="font-family:宋体">子宫瘢痕妊娠？ </span><span style="font-family:Calibri">3.</span><span style="font-family:宋体">中度贫血。入院后给完善必要检查，充分讨论及评估病情，于</span><span style="font-family:Calibri">2022.11.03</span></span><span style=";font-family:宋体;font-size:14px">在</span><span style=";font-family:宋体;font-size:14px"><span style="font-family:宋体">超声监测下无痛清宫术，手术开始即刻出现急性大出血约</span><span style="font-family:Calibri">700ml</span><span style="font-family:宋体">，妇科熊兴令主任立即开启紧急救治流程，在山东支医专家徐丽华教授主持下，成立紧急救治小组。给病人迅速建立快速静脉双通道，麦角新碱</span><span style="font-family:Calibri">0.2mg</span><span style="font-family:宋体">肌肉注射，持续按摩按压子宫，静滴氨甲环酸，紧急合血输血，阴道流血减少后给予钳夹大部分妊娠组织，最后给予宫腔球囊压迫阴道填塞纱布止血，最终病人阴道流血得以控制。术后予以甲氨蝶呤药物保守治疗，</span></span><span style="font-family: 宋体;font-size: 14px">监测</span><span style=";font-family:宋体;font-size:14px"><span style="font-family:宋体">血</span><span style="font-family:Calibri">HCG</span><span style="font-family:宋体">下降不满意，再次行磁共振检查，考虑为子宫瘢痕妊娠残留，剖宫产瘢痕妊娠 </span><span style="font-family:Calibri">III</span><span style="font-family:宋体">型。</span></span><span style=";font-family:宋体;font-size:14px">遂</span><span style=";font-family:宋体;font-size:14px"><span style="font-family:宋体">于</span><span style="font-family:Calibri">2022.11.11</span><span style="font-family:宋体">行“双侧子宫动脉结扎</span><span style="font-family:Calibri">+</span><span style="font-family:宋体">子宫瘢痕妊娠物清除</span><span style="font-family:Calibri">+</span><span style="font-family:宋体">子宫修补</span><span style="font-family:Calibri">+</span><span style="font-family:宋体">双侧输卵管结扎</span><span style="font-family:Calibri">+</span><span style="font-family:宋体">盆腔粘连分解</span><span style="font-family:Calibri">+</span><span style="font-family:宋体">宫腔留置球囊导尿管术”，成功切除子宫瘢痕处妊娠病灶。现患者平稳出院。</span></span></p><p style="text-indent:28px"><span style=";font-family:Calibri;font-size:14px"> </span></p><p style="text-indent:28px"><span style=";font-family:宋体;font-size:14px">瘢痕妊娠是妇科医生经常会面临的凶险病例，该病人的成功救治，为我们以后临床工作中此类病人的处理积累了宝贵经验，同时是我院妇科急危重症患者处理水平的体现，提升了我科危急重症处理的能力。</span></p><p><span style="font-size: 12px;">来源：城口妇幼保健院</span></p><link rel="stylesheet" href="//bbs.cktcw.cn/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_W6i" id="wcn_editor_css"/> 医疗水平越来越好了 每个妈妈都好伟大:hug::hug:医护人员辛苦了
页:
[1]