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目的探讨剖宫产切口疤痕妊娠的诊断及治疗方法。方法回顾性分析我科2013年10月至2015年10月收治的剖宫产切口疤痕妊娠(CSP)22例患者临床资料。结果超声确诊CSP 19例,其中11例患者药物保守治疗加超声引导下清宫术;8例患者直接采用开腹妊娠病灶切除术治疗,其中1行开腹妊娠病灶切除术进行治疗时出现大出血转行全子宫切除术。超声误诊先兆流产3例,在行清宫术不良后转行开腹妊娠病灶切除术。全部22例患者均治愈,预后效果良好。但采用药物保守治疗的住院时间显著长于采用直接手术治疗的患者,但其住院费用显著低于采用直接手术的患者。结论 CSP病情特异性不高,确诊方法主要依靠B超检查,但临床B超诊断误诊率较高。药物保守治疗及手术治疗各有利弊,需要根据患者情况采取个性化治疗方案。
Objective To investigate the diagnosis and treatment of cesarean section scar pregnancy. Methods The clinical data of 22 patients with cesarean incisional scar pregnancy (CSP) who were treated in our department from October 2013 to October 2015 were retrospectively analyzed. Results Ultrasound diagnosed CSP in 19 cases, of which 11 cases of conservative treatment of patients plus ultrasound-guided radical mastectomy; 8 cases of patients directly with open excision of pregnancy surgery, including 1 line of open surgery for focal resection for hemorrhage occurred in the switch Hysterectomy. Ultrasound misdiagnosed threatened abortion in 3 cases, after the line of curettage dysplasia switch to open abdominal excision of pregnancy. All 22 patients were cured, the prognosis is good. However, conservative treatment with hospital stay was significantly longer than patients treated with direct surgery, but the hospitalization costs were significantly lower than those with direct surgery. Conclusion The specificity of CSP is not high, and the diagnosis depends mainly on B-ultrasound. However, the diagnostic rate of B-ultrasound diagnosis is high. Conservative treatment and surgical treatment of each have their own advantages and disadvantages, need to be based on the patient’s condition to take personalized treatment.