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目的讨论剖宫产术后子宫切口瘢痕部位妊娠(CSP)的诊断和治疗,最大可能的保留妇女生育功能。方法回顾性分析我院收治的剖宫产术后瘢痕部位妊娠患者的临床资料。结果有剖宫产史、停经或停经后阴道出血、血清人绒毛膜促性腺激素(β-HCG)升高、彩超提示子宫下段切口部位不均质团块、甚至可见孕囊患者27例。先用氨甲喋呤(MTX)杀胚治疗22例,杀胚治疗后,必要时清宫或介入栓塞治疗后清宫。5例直接采用子宫动脉介入栓塞治疗。结论剖宫产史及彩超可为CSP提供重要诊断依据,氨甲喋呤杀胚治疗后可避免清宫或有效减少清宫术中出血量,子宫动脉栓塞治疗也是一种有效的治疗方法,这些方法可最大可能地保留女性的生育功能。
Objective To discuss the diagnosis and treatment of uterine incision scar site pregnancy (CSP) after cesarean section, and to keep women’s reproductive function to the maximum extent possible. Methods The clinical data of pregnant patients with cicatricial cesarean section in our hospital were analyzed retrospectively. The results of cesarean section history, menopause or postmenopausal vaginal bleeding, serum human chorionic gonadotropin (β-HCG) increased, color Doppler ultrasound prompted the lower uterine incision site heterogeneous mass, and even gestational sac patients in 27 cases. First methotrexate (MTX) to kill embryos in 22 cases, kill embryos after treatment, if necessary, or after intervention in the treatment of ectopic end of the Qing Palace. 5 cases of uterine artery embolization directly. Conclusion Cesarean section history and color Doppler ultrasound can provide an important diagnostic basis for CSP, methotrexate to kill the embryo can be avoided after curettage or reduce the amount of curettage bleeding, uterine artery embolization is also an effective treatment, these methods may as soon as possible Retain female reproductive function.