剖宫产疤痕妊娠22例床分析.docVIP

剖宫产疤痕妊娠22例临床分析 　　[摘要] 目的 探讨剖宫产疤痕妊娠（CSP）临床特点，提高对剖宫产疤痕妊娠的早期认识，采取有效的个体化治疗方法，提高治疗效果。方法 回顾性分析整群选取2011年1月―2014年9月该院收治的22例剖宫产疤痕妊娠（CSP）病例的临床表现、辅助检查、治疗方法及效果。结果 6例行MTX肌注保守治疗成功；16例行双侧子宫动脉化疗栓塞术+清宫术，15例成功；1例因患者要求行剖腹探查+疤痕（妊娠物）锲形切除术。结论 超声检查可用于剖宫产疤痕妊娠早期诊断，根据患者具体情况制定个体化治疗方案，治疗过程中注意病情变化，在安全有效的基础上，将对患者的损伤降到最低。 中国论文网 /6/viewhtm 　　[关键词] 剖宫产；疤痕妊娠；MTX；子宫动脉化疗栓塞 　　[中图分类号] R714.22 [文献标识码] A [文章编号] 1674-0742（2015）10（b）-0106-03 　　Clinical Analysis of 22 Cases of Cesarean Section Scar Pregnancy 　???XU Yun 　　Departments of Obstetrics and Gynecology， Yixing Peoples Hospital， Yixing， Jiangsu Province， 214200 China 　　[Abstract] Objective To discuss the clinical characteristics of cesarean scar pregnancy （CSP） and deepen our understanding on its early state so as to find out a personalized treatment scheme for better outcomes. Methods A retrospective analysis was done on 22 CSP patients who were admitted to our hospital between January 2011 and September 2014 concerning their clinical manifestation， auxiliary inspection， treatment methods and efficacy. Results Conservative treatment or intramuscular injection of MTX was successfully performed on 6 patients； bilateral uterine arterial chemoembolization combined with curettage was performed on 16 patients with 15 treated successfully； exploratory laparotomy combined wedge resection of scars（pregnancy tissue） was done on 1 patient in accordance to his （her） will. Conclusion Ultrasonic inspection can be used for early diagnosis of CPS， while for its treatment， personalized treatment scheme according to patients concrete conditions combined with attention closely paid to changes of disease can effectively minimize injury for patients. 　　[Key words] Caesarean section； Scar pregnancy； MTX； Uterine artery embolization 　　剖宫产疤痕妊娠（CSP）是是一种特殊部位的异位妊娠，指胚胎着床于有剖宫产史孕妇子宫下段的剖宫产切口疤痕处，为剖宫产手术的远期并发症。近年来由于剖宫产率居高不下，此病的发生率呈上升趋势，如处理不当，可能使患者失去子宫，甚至危及生命[1]。该院2011年1月―2014年9月共收治的剖宫产疤痕部位妊娠22例，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　该院2011年1月―2014年9月共收治CSP患者22例，年龄24～41