剖宫产切口瘢痕妊娠35例诊治分析

Cesarean Section Pregnancy:A clinical analysis of 35 cases

目的探讨剖宫产切口瘢痕妊娠(CSP)的病因、诊断及治疗方法。方法回顾性分析2003年1月—2008年8月我院妇科收治的35例CSP患者的临床表现、诊断、治疗与结局。结果35例CSP患者的平均年龄33.4岁,发病距末次行剖宫产术时间为8个月～19年,平均6.2年。最常见的临床表现为停经和阴道流血,其中20例发生阴道大出血。有16例患者最初被外院误诊为宫内妊娠。通过剖宫产术史、妇科检查和超声、磁共振等实验室检查综合分析做出诊断。治疗方法主要包括宫腔镜治疗、局部病灶切除术、全子宫切除术和保守性治疗。35例患者治疗后均恢复良好。结论CSP临床较少见,易误诊,对有剖宫产术史的患者应结合妇科检查及实验室检查早期明确诊断,宫腔镜治疗为CSP的治疗提供了新的思路。

Objective To explore the pathogenesis,early diagnosis and pertinent treatment of cesarean scar pregnancy(CSP).Methods The clinical presentations,diagnoses,treatments and outcomes of thirty-five patients with CSP in Shengjing Hospital of China Medical University from January 2003 to August 2008 were retrospectively analyzed.Results The average age of the patients was 33.4 years.The interval from the last cesarean delivery to diagnosis ranged from 8 months to 9 years,with an average interval of 2 years.The mo...