【摘要】 目的探讨剖宫产瘢痕妊娠(CSP)的临床诊断和治疗方法。方法对2003年7月至2011年12月我院收治的26例CSP患者的临床资料进行回顾性分析。结果 26例患者中,24例经阴道超声明确诊断;对26例患者分别行甲氨蝶呤(MTX)治疗加清宫术;子宫动脉明胶海绵微粒栓塞治疗,开腹病灶清除术及子宫修补术等,1例患者行经腹子宫次全切除术。结论阴道超声是诊断剖宫产瘢痕妊娠(CSP)的主要依据;孕囊注射甲氨蝶呤后行病灶清除,可减少并发症的发生;子宫动脉栓塞治疗用于CSP大出血处理安全有效,开腹清除病灶适合大出血且生命体征不稳定的患者。更多还原

【Abstract】 Objective To investigate clinical diagnosis and treatment of cesarean scar pregnancy (csp).MethodsThe clinical data of 26 cases of cesarean scar pregnancy from July 2003 to December 2011 were analyzed retrospectively.Results26 patients were all cured.Among which patients received methotrexate(MTX) single dose intramuscular injection,puncture injection in gestational sac with MTX through transvaginal ultrasound mornitoring,selective bilateral uterine artery embolization using gelfoam mote,focus clearance and repair in the caesarean section scar by open surgery respectively.Only 1 patient received subtotal hysterectomy via abdomen.ConclusionTransvaginal ultrasound mornitoring is the main basis for diagnosing cesarean scar pregnancy,locally injecting methotrexatein cases of CSP is minimally invasive and leads to a fewer complications.Interventional therapy is effective and safe for treatment of cesarean scar pregnancy massive hemorrhage.The operative treatment is effective for emergeny treatment of cesarean scar pregnancy.更多还原