子宫切口瘢痕妊娠42例临床分析

Clinical analyses of forty-two cases of cesarean scar pregnancy

目的探讨子宫切口瘢痕妊娠的早期诊断及其对预后的影响。方法2006年5月至2011年2月我院妇科收治子宫切口瘢痕妊娠患者42例，回顾性分析其临床资料。结果42例患者均行B超检查，提示子宫前壁下段有孕囊或不均质回声包块。39例保守治疗成功，3例行病灶清除加修补术。结论子宫切口瘢痕妊娠的早期诊断依靠B超检查，彩色超声是诊断的可靠依据。绒毛种植在瘢痕部位且向官腔发展，B超监测下人工流产术，出血量多即行子宫动脉栓塞，术后行清宫术；绒毛种植在瘢痕凹陷处向宫壁发展，子宫动脉栓塞术后B超监测下清宫术是一种安全且有效的治疗方法。

Objective To investigate the early period cesarean scars pregnancy diagnosis and its influence on prognosis. Methods Clincal data of 42 cases diagnosed as cesarean scar pregnancy from May 2006 to February 2011 treated in our hospital were retrospective analysed. Results All cases underwent B ultra- sound examination ,which showed gestational sacs or inhomogeneous echo-enclosed mass in the lower segment of anterior wall of uterus. Thlrty-nine cases were successfully conservatively treated ,3 cases underwent cleanrance of focal lesion and neoplasty. Conclusion The cesarean scar pregnancy diagnosis depends on a B ultra-sound examination, and the color Doppler ultra sound is reliable for the diagnosis. Floss plants in the crater of scar and developed to uterus wall. Curettage guided by B ultra-sound after uterine artery embolization is a safe and efficient treatment method.