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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 investigate the early diagnosis and treatment of uterine scar pregnancy after cesarean section. Methods The history, clinical manifestation, diagnosis and treatment of 13 CSP patients admitted to Siu Lam Hospital of Southern Medical University from January 2003 to December 2010 were retrospectively analyzed. Results Cystoscopy puncture injection of MTX + curettage in 7 cases; under hysteroscopic resection of the pregnancy in 4 cases, of which 1 case of intraoperative bleeding due to active, diverted to the lower part of the uterine segment of pregnancy removal of the lower part of the uterus repair; Direct line of open the lower part of the uterus pregnancy removal + repair of the lower uterine segment in 2 cases. All cases were cured and discharged. Conclusion Cesarean section in patients with pregnancy again, in the first trimester vaginal ultrasound examination, early diagnosis of CSP has important value; CSP treatment of a variety of application of cervical puncture through the pregnancy capsule injection of MTX + curettage is an effective method of early treatment of CSP in primary hospitals .