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目的探讨剖宫产术后子宫瘢痕妊娠病例的临床特点、诊断方法及治疗方案。方法回顾性分析了2010年6月至2012年5月某院收治剖宫产术后子宫瘢痕妊娠患者7例的临床资料。结果 7例中6例表现为不规则阴道出血,其中4例因误诊行清宫术或药物流产术后大出血,患者均通过阴道B超确诊。治疗方法包括单纯药物治疗、药物治疗+病灶去除术、子宫动脉栓塞+病灶去除术等,病灶去除术包括使用B超监视下或宫腹腔镜监视下清宫术等。患者均治愈出院。结论剖宫产术后子宫瘢痕妊娠虽然比较少见,但易误诊,阴道超声是最有效的诊断方法,治疗方法应根据患者的具体情况进行个体化治疗。
Objective To investigate the clinical features, diagnosis and treatment of uterine scar pregnancy after cesarean section. Methods The clinical data of 7 patients with uterine scar pregnancy after cesarean section were collected from June 2010 to May 2012 in our hospital were retrospectively analyzed. Results Of the 7 cases, 6 showed irregular vaginal bleeding, of which 4 were misdiagnosed as curettage or postoperative medical abortion bleeding, the patients were diagnosed by vaginal ultrasonography. Treatment includes simple drug therapy, drug therapy + lesion removal, uterine artery embolization + lesion removal and so on, the lesion removal, including the use of B-ultrasound or palace laparoscopic monitoring under Qing Palace surgery. Patients were cured and discharged. Conclusion Although pregnancy of uterine scar after cesarean section is relatively rare, it is easy to be misdiagnosed and vaginal ultrasonography is the most effective method for diagnosis. The treatment should be individualized according to the specific conditions of patients.