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目的探讨彩超监视下孕囊穿刺术联合宫腔镜治疗宫颈妊娠的价值。方法12例宫颈妊娠患者采用先行彩超监视下孕囊穿刺术,囊内注入MTX 50 mg杀胚胎治疗,待胚胎死亡、孕囊坏死后再行宫腔镜检查及负压吸引人流术的治疗方案。结果12例宫颈妊娠病例经该法治疗后均成功,治愈率为100%。治疗过程中总出血量均≤400 ml,平均(224±15)ml,术后病率仅8.3%(1/12),平均住院时间14(12~18)d。结论彩超监视下孕囊穿刺术联合宫腔镜治疗宫颈妊娠在保证了患者生命安全的同时又保全了患者的生育能力,该法具有较好的治疗效果,值得临床推广运用。
Objective To investigate the value of gestational sac puncture combined with hysteroscopy in the treatment of cervical pregnancy under color Doppler ultrasound. Methods Twelve cases of cervical pregnancy underwent primary cystoscopy with gestational sac puncture and intrauterine injection of MTX 50 mg to kill the embryo. After the embryo died and the cyst was necrotic, hysteroscopy and negative pressure artificial abortion were performed. Results All 12 cases of cervical pregnancy were successfully treated by this method and the cure rate was 100%. The total amount of bleeding in the course of treatment was ≤400 ml, with an average of (224 ± 15) ml. The postoperative morbidity was only 8.3% (1/12) and the average length of stay was 14 (12-18) days. Conclusion Pregnancy cystoscopy combined with hysteroscopy under ultrasound-guided surveillance of pregnancy for cervical pregnancy has ensured the patient’s life safety while preserving the patient’s fertility. The method has good therapeutic effect and is worthy of clinical promotion and application.