剖宫产术后子宫疤痕妊娠27例临床分析  

Clinical Analysis of 27 Cases with Cesarean Scar Pregnancy

作　　者：顾丽萍[1] 戴建荣[1] 

机构地区：[1]苏州市立医院本部妇产科,江苏省苏州市215000

出　　处：《医学理论与实践》2014年第24期3248-3249,3240,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨剖宫产术后子宫疤痕妊娠(Cesarean scar pregnancy,CSP)的诊断和治疗。方法:对我院收治的27例剖宫产术后子宫疤痕妊娠的临床资料进行回顾性分析。结果:(1)27例CSP患者首诊误诊15例,误诊率55.56%;(2)单纯的药物流产或清宫手术无1例成功,而甲氨蝶呤(Methotrexate,MTX)单一治疗的成功率为36.36%;(3)子宫动脉栓塞+清宫治疗在提高成功率、降低输血率、缩短住院时间方面具有明显优势;(4)2例MTX治疗+宫腔镜手术失败而中转开腹手术,术中证实为Ⅱ型CSP。结论:CSP的临床误诊率高,彩色多普勒检查是主要的诊断方法。对于CSP,应尽量做到早期诊断,并最好做到CSP的分型,以选择合适的治疗方法。Objective ：To explore the diagnosis and individualized treatment of cesarean scar pregnancy （CSP） .Meth‐ods ：The clinical data of 27 patients with CSP were analyzed retrospectively .Results ：（1） 15 patients were misdiagnosed , the misdiagnosis rate was 55 .56% .（2） The treatment with drug abortion or induced abortion only was not successful , and the successful rate of the treatment with Methotrexate （M TX） was 36 .36% .（3） The uterine artery embolization followed by induced abortion showed high successful rate ,less bleeding and short admission times .（4） 2 patients were treated by open surgery because of failure of the treatment with M TX followed by hysteroscopy ,and were confirmed the type Ⅱ CSP .Conclusion ：The misdiagnosis rate of CSP was high ,Color Doppler ultrasound examination was the ma‐jor diagnostic method .Early diagnosis CSP and individualized treatment with it’s type was important .

关 键 词：疤痕妊娠 剖宫产 

分 类 号：R714.2[医药卫生—妇产科学]