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目的探讨剖宫产后子宫瘢痕处妊娠的处理方法和效果。方法选取本院2012年1月~2013年1月收治的35例剖宫产后子宫瘢痕处妊娠患者,回顾分析患者的临床资料,并进行跟踪随访。结果 35例剖宫产后子宫瘢痕处妊娠患者,停经后阴道出血32例,量中,伴有轻微腹痛。12例患者给予子宫切除术,15例患者在B超监护下吸宫后给予甲氨蝶呤药物治疗成功,1例患者由于宫外孕失血性休克转入院,4例给予开腹楔型切除术。另外3例患者未出现显著阴道出血,无显著腹痛症状,给予宫腔镜下胚物切除术结合甲氨蝶呤宫颈注射治疗,治疗成功。结论治疗剖宫产后子宫瘢痕处妊娠时,需要尽快采取超声诊断,采取及时有效的处理方法。在治疗剖宫产后子宫瘢痕处妊娠时,可以采用药物和微创手术进行保守治疗,并要全面认识剖宫产后瘢痕处妊娠,增加确诊率。
Objective To investigate the treatment method and effect of pregnancy after cesarean section uterine scar. Methods From January 2012 to January 2013, 35 pregnant women with uterine scar after cesarean section were enrolled in this study. The clinical data of the patients were retrospectively analyzed and followed up. Results 35 cases of cesarean section uterine scar pregnancy, postmenopausal vaginal bleeding in 32 cases, the amount, with mild abdominal pain. Twelve patients underwent hysterectomy. Fifteen patients were successfully treated with methotrexate after being aspirated by B-ultrasound. One patient was admitted to hospital for hemorrhagic shock due to ectopic pregnancy, and four patients underwent open-ended wedge resection. The other 3 patients did not show significant vaginal bleeding, no significant symptoms of abdominal pain, given hysteroscopic excision combined with methotrexate cervical injection therapy, the successful treatment. Conclusion Treatment of uterine cesarean section after cesarean pregnancy, need to take ultrasound as soon as possible to take timely and effective treatment. In the treatment of cesarean section uterine scar pregnancy, you can use drugs and minimally invasive surgery for conservative treatment, and to fully understand the pregnancy after cesarean section scar, increase the diagnosis rate.