剖宫产瘢痕部位妊娠16例临床分析(1)
剖宫产瘢痕部位妊娠16例临床分析,子宫瘢痕部位妊娠,诊断,治疗
【摘要】 目的 探讨剖宫产瘢痕部位妊娠的诊治方法。方法 回顾分析笔者所在医院8年来收治的16例剖宫产瘢痕部位妊娠的诊治过程，对其结局进行分析以探讨最佳的早期诊断和处理方式。结果 16例中14例早期B超诊断而行相应治疗，2例在早些年未予诊断明确于人流时中大出血。16例中仅2例药物保守治疗成功，4例行子宫动脉栓塞术并清宫治愈，3例切除子宫，7例剖腹探查行瘢痕部位切除并修补子宫。结论 剖宫产瘢痕部位妊娠是近年来常见的妊娠并发症，有随时可能发生大出血的危险。有剖宫产史者早孕流产前应常规彩超检查，警惕剖宫产瘢痕部位妊娠。处理方法有药物治疗、子宫局部瘢痕肌层过薄者以开腹手术为宜，根据局部情况可行局部修补或子宫切除术，有条件者可行介入治疗或介入后清宫术。 【关键词】 子宫瘢痕部位妊娠； 诊断； 治疗
Clinical analysis on 16 cases of cesarean scar pregnancy QIU Yu-lan，XUE Xiu-zhen.Luanchuan Family Planning Technology Station，Luanchuan 471500，China
【Abstract】 Objective To explore the treatment on cesarean scar pregnancy (CSP).Methods 16cases of CSP were retrospected,to explore the best method with early diagnosis and treatment after the results were analyzed in the past 8 years.Results 14 cases were diagnosed with ultrasound in early,while the 2 mistaken diagnosed cases experienced massive haemorrhage during uterine curettage,2 cases were cured by drug treatment,4 were cured by uterine curettage after intervention treatment,3 cases were done hysterectomy,7 were treated by transabdominal exploring operation in 16 cases CSP.Conclusion CSP was dangerous.The guildline for ceaseren section must be strictly obeyed.The early pregnant woman with uterus cutting history should had routine ultrasonic scan to exclude. The treatment method had drug treatments.Transabdominal exploring operation was the best method for the patient with uterus breaking. Uterine curettage after intervention treatment heeded to be considered. ......
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