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目的总结剖宫产瘢痕妊娠的临床特点,探讨适合基层医院的CSP早期诊断及治疗方法。方法回顾分析2009年1月至2013年6月新乡市妇幼保健院收治的36例子宫下段剖宫产瘢痕妊娠患者的临床资料及诊疗经过。结果 36例患者中29例术前阴道彩色超声确诊,7例术后病理确诊。5例药物保守治疗后清宫术顺利,术中出血Foley水囊压迫止血成功15例,剖宫产瘢痕妊娠病灶清除术+修补术12例。外院转入急诊行子宫切除术4例。结论阴式彩超是基层医院诊断CSP的首选方法。药物保守治疗后清宫术、Foley水囊压迫止血法、经腹剖宫产瘢痕妊娠病灶清除术+修补术三种方法是可供基层医院选择的治疗方案。
Objective To summarize the clinical features of cesarean scar pregnancy and to explore the early diagnosis and treatment of CSP for primary hospital. Methods The clinical data of 36 cases of cesarean scar pregnancy from January 2009 to June 2013 in Xinxiang Maternal and Child Health Hospital were analyzed retrospectively. Results Among the 36 patients, 29 cases were diagnosed by preoperative vaginal ultrasound and 7 cases were confirmed by pathology. Five cases of conservative treatment of hysterectomy was successful, intraoperative bleeding Foley hemostasis compression hemostasis in 15 cases, cesarean scar pregnancy repair + repair in 12 cases. Outside the hospital transferred to emergency line hysterectomy in 4 cases. Conclusion Vaginal ultrasound is the preferred method of diagnosis of CSP in primary hospitals. After conservative treatment of drug curettage, Foley sac compression hemostasis, cesarean section cesarean scar pregnancy removal surgery + repair three methods are available for primary care hospital treatment options.