剖宫产术后子宫瘢痕妊娠13例诊治分析  

Analysis of 13 Cases of Cesarean Scar Pregnancy

作　　者：梁焕瑜[1] 

机构地区：[1]南方医科大学附属小榄医院,广东中山528415

出　　处：《中国医药指南》2011年第12期17-18,共2页Guide of China Medicine

摘　　要：目的探讨剖宫产术后子宫瘢痕妊娠的早期诊断及治疗方法。方法对南方医科大学附属小榄医院2003年1月至2010年12月收治的13例CSP患者的病史、临床表现、诊治经过进行回顾性分析。结果行经宫颈孕囊穿刺注射MTX+清宫术7例;行宫腔镜下妊娠物电切术4例,其中1例术中因活动性出血不止,改行开腹子宫下段妊娠物清除+子宫下段修补术;直接行开腹子宫下段妊娠物清除+子宫下段修补术2例。所有病例均痊愈出院。结论剖宫产史患者再次妊娠,于孕早期行阴道彩超检查,对早期诊断CSP有重要价值;CSP治疗方法多种,应用经宫颈穿刺孕囊注射MTX+清宫术是基层医院早期治疗CSP的有效方法。Objective To discuss the early diagnostic methods and treatment strategies of cesarean scar pregnancy（CSP）.MethodsFrom January 2003 to December 2010,13 patients of CSP who were admitted to our hospital were studied retrospectively,and the clinical manifestation,diagnosis,therapies of cesarean scar pregnancy（CSP） were investigated.ResultsCurettage after MTX locally injections were undertaken in 7 cases.4 patients were removed of conceptive tissues underwent hysteroscopy,while conversion to laparotomy lesion excision was performed in one of them.Laparotomy partial lesion resection and uterine neoplasty were undertaken in 2 patients.All patients recovered.ConclusionsTransvaginal color ultrasonography can play an important role in early diagnosis of CSP in early pregnant woman with cesarean section history.Curettage after MTX locally injection is a feasible early treatment of CSP in Primary Hospital.

关 键 词：剖宫产子宫瘢痕 妊娠 异位 甲氨蝶呤 

分 类 号：R719.8[医药卫生—妇产科学]