[1]汪清,郑瑞莲,陈敏,等.宫腔镜技术诊治流产后妊娠物残留的临床价值[J].中国微创外科杂志,2007,07(11):1101-1105.
　Wang Qing,Zheng Ruilian,Chen Min,et al.Clinical Significance of Hysteroscopy on the Diagnosis and Treatment of Abortive Remnants[J].Chinese Journal of Minimally Invasive Surgery,2007,07(11):1101-1105.
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宫腔镜技术诊治流产后妊娠物残留的临床价值()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年11期
页码:
1101-1105
栏目:
出版日期:
2007-11-20

文章信息/Info

Title:
Clinical Significance of Hysteroscopy on the Diagnosis and Treatment of Abortive Remnants
作者:
汪清; 郑瑞莲; 陈敏; 谢锋; 隋龙*
复旦大学附属妇产科医院宫颈疾病诊治中心，上海200011
Author(s):
Wang Qing;  Zheng Ruilian;  Chen Min;  et al.
Center of Cervix Diseases, Obstetrics and Gynecology Hospital, Medical Center of Fudan University, Shanghai 200011, China
关键词:
宫腔镜; 流产后妊娠物残留; 米非司酮
Keywords:
Hysteroscopy; Remnant trophoblastic tissue; Mifepristone
分类号:
R713.4
文献标志码:
A
摘要:
目的探讨应用米非司酮配合宫腔镜技术诊治流产后妊娠物残留的临床价值。方法对56例早期流产术后残留再次清宫术后仍有宫内妊娠物残留者，应用米非司酮配合宫腔镜技术进行诊断并手术处理。宫腔镜术前用米非司酮50 mg，每日2次，连续口服7天；对宫腔镜手术后妊娠物残留仍未完全去除者继续用米非司酮14天。结果1例宫角妊娠物残留者术中出血200 ml，无其他并发症。手术一次完全去除残留物者40例，术后2周复查血βhCG均正常，B超宫腔内无占位性病变；另16例有宫角部残留组织，术后口服米非司酮，均于术后2个月内B超证实残留组织完全排出，血βhCG正常。33例术后随访1~6个月，平均3个月，阴道流血、闭经、排液、腹痛等症状消失，月经恢复正常。结论应用米非司酮配合宫腔镜技术联合治疗流产后妊娠物残留临床效果满意。
Abstract:
ObjectiveTo explore the clinical effects of hysteroscopy combined with mifepristone on the diagnosis and treatment of abortive remnants.MethodsA total of 56 patients with abortive remnants, who had undergone uterine curettage after the abortion, were treated with mifepristone combined with hysteroscopy. Before hysteroscopy, mifepristone was taken orally at a dose of 100 mg daily (50 mg, Bid) for 7 days. After the surgery, those who still had remnants in the uterus were given mifepristone at the same dose for 14 days.ResultsNo patient had complication during and after the hysteroscopy except for one, who had abortive remnants at the uterine horn, experienced blood loss of 200 ml. In 40 patients, the abortive remnants were removed completely by hysteroscopy. Two weeks after the surgery, laboratory examination of the patients showed normal blood βhCG, and Bultrasonography revealed no spaceoccupying mass in the uterus. In the other 16 patients, remnants were detected in the uterine horns after the hysteroscopy, and mifepristone was prescribed. These patients received reexaminations 2 months after the operation, and no abnormal blood βhCG or remnants in the uterus was found. Among the 56 patients, 33 were followed up for 1-6 months (mean, 3 months). During the followup, their symptoms including vaginal bleeding or drainage, amenorrhea, and abdominal pain disappeared, and the menstruation became normal.ConclusionsHysteroscopy combined with mifepristone is an effective measure to diagnose and treat abortive remnants.

参考文献/References:

[1]夏恩兰,段华,黄晓武,等.宫腔镜宫内异物取出术及其监护方法的探讨.中国实用妇科与产科杂志，2002，18(11):673-674.
[2]陈萍,林俊,徐开红.宫腔镜诊治宫内妊娠物残留56例分析.浙江预防医学,2005,17(12):48-49.
[3]徐大宝,薛敏.宫腔镜在不全流产诊治中的价值.中国内镜杂志,2004,10(3):38-40.
[4]张仲芳，施如霞，沈美华，等.宫腔镜联合B超诊治早期宫角妊娠.中国微创外科杂志,2005,5(6):476-477.
[5]王永莉,傅桐馨,李剑霞.宫腔镜在诊治宫内妊娠物残留中的作用.新疆医科大学学报,2000,23(3):262.
[6]Cohen SB,KalterFerber A,Weise BS,et al.Hysteroscopy may be the method of choice for management of remnant trophoblastic tissue.J Am Assoc Gynecol Laparosc,2001,8:199-202.
[7]熊金玲,张慧莉.应用宫腔镜与B超联合诊治妊娠组织残留的临床分析.中国医师杂志,2006,8(4):541.
[8]杨业洲,曹泽毅,韩学研,等.米非司酮对人早孕绒毛细胞增殖和凋亡的影响.中华妇产科杂志,1998,33(5):268-270
[9]郭桂芝.米非司酮用于胎盘残留的效果观察.中国妇幼保健,2006,21(19):2762.

备注/Memo

备注/Memo:
*通讯作者
更新日期/Last Update: 2013-12-09