11例剖宫产后瘢痕妊娠的临床治疗分析

摘要

Objective To explore the clinical characteristic, early diagnosis and treatment of cesarean scar pregnancy. Method 11 cases of CSP from my department were retrospectively analyzed from June 2012 to January 2017. Result 10 cases in these patients were found to have abortion histroy. Of which, 4 cases were treated with methotrexate, 5 cases were treated with pregnancy removal surgery accompanied with hysteroscope under ultrasound monitoring after uterine artery embolization and 2 cases were treated with pregnancy removal surgery and transvaginal uterine scar repair after uterine artery embolization and methotrexate. All of 11 cases of CSP were treated successfully. Conclusion The clinical treatment of CSP should be based on ultrasonic classification, a risk factor of bleeding occurred, and the patient's pregnancy requirements to select. Methotrexate, intervention and hysteroscopic have been proved to be safe and effective in the treatment of CSP.%目的 探讨剖宫产后瘢痕妊娠(Cesarean scar pregnancy,CSP)的临床特点、早期诊断及治疗方法.方法 对本院妇科2012年6月至2017年1月收治的11例CSP患者临床资料进行回顾性分析.结果 11例CSP患者中,10例有剖宫产后人工流产史.其中4例采用甲氨蝶呤治疗,5例于子宫动脉栓塞后在超声监测下行宫腔镜下妊娠物清除术,2例于子宫动脉栓塞及甲氨蝶呤治疗后行妊娠物清除术+经阴道子宫瘢痕修补术,11例患者均治疗成功.结论 临床中CSP的治疗需依据超声分型、发生出血的危险因素以及患者的生育要求进行选择,采用甲氨蝶呤、介入及宫腔镜治疗安全有效.