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目的 探讨子宫峡部剖宫产切口处早期妊娠的临床表现、诊断及治疗。方法 分析 1996年 1月至 1999年 12月经药物保守治疗的子宫峡部剖宫产切口处早期妊娠 14例。结果 14例子宫峡部剖宫产切口处早期妊娠患者起病于无痛性阴道少量出血 ,同时伴有血 β HCG升高。多普勒超声显示子宫峡部剖宫产切口处明显膨大 ,并可见孕囊或混合性团块附着于该处 ,孕囊与膀胱壁间的子宫肌层菲薄。其中 12例经结晶天花粉宫颈注射、口服米非司酮或肌注氨甲喋呤等治疗 ,血 β HCG降至正常。另有 2例行全子宫切除。结论 子宫峡部剖宫产切口处早期妊娠是一种新的剖宫产远期并发症 ,早期诊断和有效的药物保守治疗能减少子宫破裂的发生 ,这将有助于保留患者的生育功能。
Objective To investigate the clinical manifestations, diagnosis and treatment of early pregnancy in uterine isthmus cesarean section. Methods From January 1996 to December 1999, 14 cases of early pregnancy were treated by conservative cesarean section in cesarean section. Results Fourteen cases of uterine isthmus caesarean section incision early pregnancy patients with a small amount of painless vaginal bleeding, accompanied by elevated blood β HCG. Doppler ultrasound showed a significant enlargement of the uterine isthmus cesarean section incision, and visible gestational sac or mixed mass attached to the Department, the gestational sac and bladder wall between the myometrium meager. Among them, 12 cases were treated by cervical injection of TCS, oral mifepristone or methotrexate intramuscular injection, blood β HCG decreased to normal. Another 2 cases of hysterectomy. Conclusion Early pregnancy in cesarean section of uterine isthmus is a new long-term complication of cesarean section. Early diagnosis and effective conservative treatment can reduce the incidence of uterine rupture, which will help to preserve the reproductive function of patients.