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目的:探讨剖宫产术后子宫瘢痕处妊娠的诊断和治疗方法。方法:回顾性分析收治的70例剖宫产术后子宫瘢痕处妊娠患者的临床资料。结果:70例患者中治疗前明确诊断39例,误诊31例。两种方法的治愈率差异有统计学意义(χ2=13.26,P<0.05)。结论:阴道彩超的应用可使剖宫产术后子宫瘢痕处妊娠早期确诊。病灶清除能提高本病的治愈率。病灶清除的方法依病灶侵入的深度不同而异。为避免大出血及子宫切除,病灶深入肌层者应首选开腹或腹腔镜下病灶切除。
Objective: To investigate the diagnosis and treatment of uterine scar pregnancy after cesarean section. Methods: The clinical data of 70 pregnant women with uterine scar after cesarean section were analyzed retrospectively. Results: Among 70 patients, 39 cases were diagnosed before treatment and 31 cases were misdiagnosed. The two methods of cure rate difference was statistically significant (χ2 = 13.26, P <0.05). Conclusion: The application of vaginal ultrasound can make uterine scar after cesarean section early pregnancy diagnosis. Lesions can improve the cure rate of the disease. The method of lesion clearance depends on the depth of invasion of the lesion. In order to avoid bleeding and hysterectomy, lesions should be preferred deep laparotomy or laparoscopic resection of the lesion.