剖宫产术后切口妊娠的诊断与治疗

Clinical analysis of ectopic pregnancy in cesarean scar

目的探讨子宫下段切口妊娠的临床诊断和治疗。方法对31例子宫切口妊娠患者的病史、临床表现、诊断方法以及治疗方法进行回顾性分析。结果 31例患者中有24例经阴道彩色多普勒超声检查确诊,确诊率77.42%;采用药物治疗8例,药物加手术治疗17例,双侧子宫动脉栓塞治疗2例,手术治疗4例。31例患者中治疗成功29例,子宫切除术2例。结论经阴道彩色多普勒超声检查可作为诊断切口妊娠的主要方法;甲氨蝶呤联合米非司酮加清宫术可作为治疗切口妊娠的主要方法。

Objective To explore the diagnosis and treatment of uterine incision pregnancy.Methods 31 patients with uterine incision pregnancy were retrospectively analyzed.Results 24 patients were accurately diagnosed by transvaginal color Doppler ultrasound（TVCDU）.The accuracy was 77.42%.5 cases were treated with drug therapy,20 cases with drugs and surgery,2 cases with bilateral uterine artery embolization and 4 cases with surgical treatment.29 patients were successfully treated and only 2 cases were treated with hysterectomy.Conclusion TVCDU is a main and accuracy method for diagnosis of uterine incision pregnancy.Methotrexate and mifepristone and curettage can be used as the main treatment of ectopic pregnancys in the cesarean scar.