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[背景]探讨剖宫产术后子宫切口瘢痕处妊娠的诊断及治疗方法.[病例报告]对2011年1月—2012年6月间收治的10例子宫下段剖宫产术切口瘢痕处妊娠病例的临床资料进行回顾性分析.10例均有剖宫产术史,停经后不规则阴道流血,经彩色多普勒超声及血β-HCG检测,10例患者全部明确诊断.10例中8例经彩色多普勒超声检查发现子宫下段切口瘢痕处妊娠囊距子宫浆膜层厚度在4mm以上,2例不足4mm.8例口服米非司酮及米索前列醇配合刮宫术治疗,7例获痊愈,1例患者因刮宫术后阴道持续活动性出血,行子宫动脉栓塞术,术后无活动性出血.2例患者进行子宫动脉栓塞术、MTX50mg子宫动脉内注入,3d后刮宫治疗成功.[讨论]子宫下段剖宫产术后切口瘢痕处病灶距子宫浆膜层厚度可作为选择治疗方法的参考依据,其中给距离大于4mm者行口服米非司酮及米索前列醇后行刮宫术可获较满意的效果,小于4mm者则可依据具体情况改用子宫动脉栓塞术等治疗方法.
[Background] To investigate the diagnosis and treatment of pregnancy at the uterine incision scar after cesarean section. [Case Report] Ten cases of cesarean section incision cicatricial pregnancy treated from January 2011 to June 2012 Of the clinical data were retrospectively analyzed .10 cases were history of cesarean section, irregular vaginal bleeding after menopause, the color Doppler ultrasound and blood β-HCG test, 10 patients were all diagnosed in all .Of 10 cases, 8 cases The color Doppler ultrasound examination found that the uterine incision scar at the gestational sac from the uterine serosa thickness of more than 4mm, 2 cases less than 4mm.8 cases of oral mifepristone and misoprostol with curettage, 7 cases were One patient had active vaginal bleeding after curettage, uterine arterial embolization and no postoperative bleeding.2 cases of uterine arterial embolization and MTX50mg intra-uterine arterial infusion were successfully treated by curettage after 3 days [ Discussion] cesarean section after cesarean section incision scar lesions from the uterine serosa layer thickness can be used as a reference method of choice, of which more than 4mm distance were given oral mifepristone and misoprostol after curettage Satisfactory results, small 4mm who can switch to treatment Uterine artery embolization case by case basis.