剖宫产子宫疤痕处妊娠67例诊治分析

目的探讨剖宫产子宫疤痕处妊娠(CSP)的早期诊断方法及评估其不同治疗方法的临床疗效。方法回顾性分析2007年7月～2012年7月深圳市人民医院收治的67例CSP病例的临床表现、辅助检查结果、治疗方法及效果。结果 66例经阴道彩超检查提示子宫疤痕处妊娠,37例行子宫动脉化疗栓塞术,2例行子宫动脉栓塞术,14例行全身静脉化疗,2例行超声引导下囊内穿刺局部化疗,4例行全子宫切除术,6例直接行清宫术,2例期待治疗,所有病例均治疗成功。结论经阴道彩色多普勒超声检查可用于早期诊断CSP,根据患者具体情况制定个体化治疗方案,治疗过程中需严密监测病情变化及治疗效果,必要时需多手段的联合应用。

The Analysis of Diagnosis and Treatment of Cesarean Scar Pregnancy on 67 Cases

Objective To explore the method of early diagnosis of cesarean scar pregnancy （CSP） and evaluate the clinical efficacy of different methods in treatment. Methods Retrospective analysis the performance, ancillary test results,treatment and results of 67 cases of CSP hospitalized in Shenzhen People＇s Hospital between July, 2007 to July, 2012. Results 66 cases were diagnosed as CSP by transvaginal color Doppler ultrasonography（TVCDUS）. 37 cases received uterine artery chemoembo-lization（UAEC）. 14 cases received systemic chemotherapy, 2 cases received transvaginal ultrasound-guided embryo aspiration plus local chemotherapy,d cases accepted laparotomy,6 cases received curettage only, 2 patients with expectant treatment. Conclusion TVCDUS can be used for early diagnosis of CSP.In order to develop individual treatment,many factors should be considered. During treatment, patienffs condition and efficacy should be closely monitored, if necessary, various means be integrated applied.