Xiao Juhua, Zhang Shouhua, Wang Fang, Wang Yuqin, Shi Zhen, Zhou Xin, Zhou Jinshui, Huang Jinshi
Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Department of General Surgery, Jiangxi Children's Hospital, Nanchang, Jiangxi Province, People's Republic of China.
Am J Obstet Gynecol. 2014 Oct;211(4):356.e1-7. doi: 10.1016/j.ajog.2014.04.024. Epub 2014 Apr 23.
The aim of this preliminary study was to investigate whether ultrasound-guided high-intensity focused ultrasound (HIFU) can play a role in treating cesarean scar pregnancy (CSP).
Between November 2011 and December 2012, 16 patients with CSP were treated with ultrasound-guided HIFU ablation. Successful treatment was defined as disappearance of CSP mass, undetectable serum beta human chorionic gonadotropin, and no serious complications such as severe bleeding, uterine rupture, or hysterectomy.
All patients were successfully treated in the outpatient department and none required readmission. After 2-5 treatment sessions, the mean time for achieving undetectable serum beta human chorionic gonadotropin was 4.94 ± 2.32 weeks, and the mean time for CSP mass disappearance was 6.69 ± 3.36 weeks. Three patients experienced moderate abdominal pain that subsided in 1-2 days, and nine patients experienced mild vaginal bleeding (<30 mL) that resolved within 2-3 days. All 16 patients had recovered their normal menstruation function at follow-up.
These preliminary results suggest that ultrasound-guided HIFU ablation is a noninvasive, feasible, and effective method for the treatment of CSP.
本初步研究旨在探讨超声引导下高强度聚焦超声（HIFU）能否在剖宫产瘢痕妊娠（CSP）的治疗中发挥作用。
2011年11月至2012年12月期间，对16例CSP患者采用超声引导下HIFU消融治疗。成功治疗的定义为CSP包块消失、血清β-人绒毛膜促性腺激素检测不到，且无严重出血、子宫破裂或子宫切除等严重并发症。
所有患者均在门诊成功治疗，无需再次入院。经过2 - 5次治疗后，血清β-人绒毛膜促性腺激素检测不到的平均时间为4.94±2.32周，CSP包块消失的平均时间为6.69±3.36周。3例患者出现中度腹痛，1 - 2天内缓解，9例患者出现少量阴道出血（<30 mL），2 - 3天内消失。16例患者在随访时月经功能均恢复正常。
这些初步结果表明，超声引导下HIFU消融是一种治疗CSP的无创、可行且有效的方法。
