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目的探讨剖宫产子宫切口瘢痕处妊娠(CSP)的早期诊断及处理。方法对2009年8月至2012年8月收治的61例CSP患者的临床资料进行回顾性分析和总结。结果 61例CSP患者首诊漏诊率高达36.1%。34例患者B超监测下行人工流产术,23例成功;余27例患者行子宫动脉甲氨蝶呤化疗输注加栓塞术,48 h内B超监视下清宫,均获成功。结论子宫切口瘢痕处早期妊娠B超诊断误诊率高,应详细询问妊娠史和生育史,并根据妊娠处血流情况及包块大小选择合适的治疗方式,以进行早期诊断和处理。
Objective To investigate the early diagnosis and treatment of pregnancy (CSP) in cesarean section incision scar. Methods The clinical data of 61 CSP patients admitted from August 2009 to August 2012 were retrospectively analyzed and summarized. Results 61 cases of CSP patients first diagnosis missed as high as 36.1%. Twenty-four patients were successfully treated with B-ultrasound for abortion, and 23 patients were successful. In the remaining 27 patients, methotrexate infusion and embolization of uterine artery were performed. Conclusions The misdiagnosis rate of early pregnancy B-ultrasonography in uterine incision scar is high. Pregnancy history and fertility history should be asked in detail. According to the blood flow in pregnancy and the size of mass, appropriate treatment should be selected for early diagnosis and treatment.