剖宫产后子宫瘢痕处妊娠34例诊断和治疗分析

目的探讨剖宫产后子宫瘢痕处妊娠（CSP）的诊断和治疗方法.方法对1990年10月至2009年10月,34例剖宫产后子宫瘢痕处妊娠的诊断和治疗进行追踪分析.结果 34例行36人次治疗.1例（2.7%）行子宫次全切除术,12例（33%）行瘢痕处超声引导下甲氨蝶呤局部注射治疗,19例（53%）行腹腔镜或开腹瘢痕处组织切除术＋瘢痕修补术,2例（5.6%）行超声引导下清宫术,2例（5.6%）行子宫动脉栓塞术＋局部甲氨蝶呤注射治疗.结论剖宫产后子宫瘢痕处妊娠应该早期诊断和早期采取个性化联合治疗方案.

Diagnosis and Treatment of Cesarean Scar Pregnancy

Objective To explore the methods for diagnosis and treatment of cesarean scar pregnancy（CSP）.Methods The diagnosis and treatment of 34 cases with cesarean scar pregnancy between October 1990 and October 2009 were carried with follow-up analysis.Results The 34 cases received 36 treatments as total.1 case（2.7%） received subtotal hysterectomy;12 cases（33%） received local injection with methotrexated（MTX） under the ultrasound guidance;19 cases（53%） received laparoscope treatment or scar tissue excision and neoplasty with open hepatectomy;2 cases（5.6%） received uterine curettage with ultrasound guidance;2 cases（5.6%） received uterine fibroid embolization and local injection with methotrexated（MTX） under the ultrasound guidance.Conclusion Cesarean scar pregnancy should be early diagnosd and treated with individual therapy.