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目的:探讨剖宫产术后子宫疤痕处妊娠的临床特点,加强对子宫疤痕处妊娠的预防、早期诊断和个性化诊疗方案的认识,提高治疗效果。方法:回顾性分析2009年3月～2011年6月在该院就诊的子宫疤痕处妊娠18例患者的发病原因、治疗方法及预后状况。结果:7例患者人工流产完成不满意,2例成功,5例转行药物治疗。15例患者行MTX药物治疗,其中12例治愈,3例转手术治疗。4例患者手术治疗后痊愈。18例患者最终均治愈。结论:导致子宫疤痕处妊娠发生的主要因素包括缺乏定期B超检查、对该病认识不足等;通过B超检查早期确诊,根据患者病情评估结果制定个性化的综合治疗方案,是治疗剖宫产术后疤痕处妊娠的有效手段。
Objective: To investigate the clinical features of pregnancy after uterine scarring after cesarean section, to improve the understanding of the prevention, early diagnosis and personalized diagnosis and treatment of uterine scar, and to improve the therapeutic effect. Methods: The etiological factors, treatment methods and prognosis of 18 pregnant women with uterine scar were analyzed retrospectively from March 2009 to June 2011. Results: Seven patients were dissatisfied with induced abortion, two were successful, and five were switched to drug treatment. Fifteen patients underwent MTX drug treatment, of which 12 were cured and 3 were surgically treated. Four patients recovered after surgery. Eighteen patients were eventually cured. Conclusion: The main factors that lead to pregnancy in uterine scar include the lack of regular B-ultrasound and lack of understanding of the disease. Early diagnosis by B-ultrasound and personalized comprehensive treatment plan based on patient’s condition assessment are the best ways to treat cesarean section Postoperative scar pregnancy an effective means.