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目的:探讨剖宫产术后子宫瘢痕处妊娠(CSP)的不同分型的相应治疗途径及疗效。方法:对8例患者的临床资料进行回顾性分析。结果:8例患者都有剖宫产史,其中3例患者早孕停经40～50天,在手术之前通过彩超确诊为剖宫产疤痕妊娠,3例因为人工流产术后以及钳刮术中出现阴道大量出血入院,以上患者术前都被误诊。2例因为怀孕(36+5)周产前出血急诊入院。该8例患者中有3例患者行米菲司酮联合甲氨蝶呤保守治疗,清宫成功后保留了生育功能,4例患者子宫次全切除,1例患者行子宫修补术+子宫下段疤痕病灶楔形切除术。结论:诊断该病的首选方法是超声检查,主要治疗方法是药物配合清宫,必要的时候可以行子宫修补加子宫疤痕病灶切除治疗。
Objective: To investigate the corresponding treatment and efficacy of different types of pregnancy (CSP) at cesarean section after cesarean section. Methods: The clinical data of 8 patients were retrospectively analyzed. Results: All 8 patients had history of cesarean section. Among them, 3 patients had their first trimester menopause 40 to 50 days, diagnosed as cesarean scar pregnancy by color Doppler ultrasonography before operation, and 3 patients had vaginal bleeding after induced abortion and forceps curettage A large number of bleeding hospitalization, the above patients were misdiagnosed before surgery. Two patients were admitted to hospital because of prenatal bleeding during pregnancy (36 + 5) weeks. Three of the eight patients underwent conservative treatment with metformin and methotrexate, retained fertility after the successful cesarean section, subtotal hysterectomy in 4 patients, and uterine repair + lower scar lesions in the uterus in 1 patient Wedge resection. Conclusion: The preferred method of diagnosis of the disease is ultrasound, the main treatment is the drug with the curettage, when necessary, uterine repair and uterine scar lesions can be removed.