剖宫产术后子宫瘢痕妊娠8例临床分析

目的:探讨剖宫产术后子宫瘢痕妊娠(CSP)的诊断和治疗方法.方法:回顾性分析我院2006年1月～2010年1月8例CSP患者临床资料,分别根据患者症状、体征及辅助检查情况,采取MTX化疗,MTX化疗联合清宫治疗,子宫动脉栓塞加清宫术,局部病灶切除术,全子宫切除术.术后注意观察并发症及定期随访.结果:MTX化疗组治愈率82％,少数患者有胃肠道症状及脱发现象；全子宫切除术组治愈率100％,患者病情恢复良好；MTX化疗联合清宫治疗组治愈率91％,子宫动脉栓塞(UAE)加清宫术组治愈率100％,月经周期恢复正常,一般情况良好.结论:剖宫产后瘢痕妊娠是少见而危险的异位妊娠,其诊断需结合患者症状体征及实验室辅助检查确定,需根据患者病情,选择合适的治疗手段.

A report on 8 cases of cesarean section scar pregnancy

Objectives： To investigate the diagnosis and treatment on cesarean section scar pregnancy （CSP）. Methods： A retrospective analysis was made on the clinical data of eight CSP patients admitted into our hospital from January, 2006 to Janu- ary,2010. Based on the patients＇ symptoms, signs and laboratory tests, they were accordingly treated with MTX chemotherapy, MTX chemotherapy combined with uterus curettage,local lesion resection and hysterectomy. Postoperative observation was made for fear of complications and the patients were regularly followed - up. Results ： In MTX chemotherapy group, 82% of patients indicated recovery and a few patients were complicated with gastrointestinal symptoms and alopecia; In hysterectomy group, the patients showed 100% recovery rate. In MTX chemotherapy combined with uterus curettage group, the curative rate was 91%. Conclusion：The cesarean section scar pregnancy is a rare and dangerous ectopic pregnancy, the diagnosis and the treatment should be made by taking into consideration a combination of factors including symptoms, signs, and laboratory test results.