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目的:研究分析剖宫产术后子宫瘢痕处妊娠(CSP)的临床特点以及处理方法,积极预防剖宫产术后子宫瘢痕处妊娠的发生,提高子宫瘢痕处妊娠的诊疗水平。方法:对我院自2011年1月至2012年12月收治的36例剖宫产术后子宫瘢痕处妊娠的诊治经历进行回顾性分析。结果:36例子宫瘢痕处妊娠患者均在我院获得确诊,其中8例经米非司酮或甲氨蝶呤(MTX)联合中药保守治疗;18例予药物保守治疗后行宫腔镜或B超监测下行清宫术,术后给予双腔导尿管球囊压迫止血,治疗成功;10例予药物保守治疗后行介入治疗。结论:剖宫产术后子宫瘢痕处妊娠病情凶险,争取早期明确诊断,采取保守治疗,采用多种治疗方式、个体化治疗,减少不良预后。
Objective: To study the clinical characteristics and treatment of pregnancy after uterine scar (CSP) after cesarean section and to actively prevent the occurrence of pregnancy in uterine scar after cesarean section and to improve the diagnosis and treatment of uterine scar. Methods: A retrospective analysis was made on the diagnosis and treatment of pregnancy in 36 cases of uterine scar after cesarean section in our hospital from January 2011 to December 2012. Results: 36 cases of uterine scar pregnancy were diagnosed in our hospital, of which 8 cases of mifepristone or methotrexate (MTX) combined with traditional Chinese medicine conservative treatment; 18 cases of drug conservative treatment after hysteroscopy or B ultrasound Surgical curettage was performed. Double-lumen catheter was used to stop hemostasis after operation. Ten patients were treated with conservative treatment before interventional therapy. Conclusion: After cesarean section uterine scar pregnancy at risk, for early diagnosis, conservative treatment, using a variety of treatment methods, individualized treatment, reduce the adverse prognosis.