子宫下段剖宫产术后切口妊娠临床治疗体会.doc

子宫下段剖宫产术后切口妊娠临床治疗体会 　　【摘要】目的：探讨子宫下段剖宫产术后切口妊娠(CSP)的临床治疗方法。方法 将96例切口妊娠患者分为三组,采用不同的方法进行治疗对照。结果 A、B组平均住院日、治疗成功率差异无统计学意义(P0.05),B组7d血β-HCG、阴道出血量下降率明显高于A组,而血β-HCG转阴时间明显少于A组,差异均有统计学意义(P0.05),C组阴道出血量、血β-HCG转阴时间、平均住院日明显少于A、B两组,C组7d血β-HCG下降率、治疗成功率明显高于A、B两组,差异均有统计学意义(P0.05)。结论 一旦确定妊娠,一定要考虑到CSP,必须进行超声检查,排除子宫切口妊娠和胎盘植入等危险因素,切忌盲目采取终止妊娠措施,以减少子宫破裂、大出血等严重并发症的发生及降低子宫切除率。 　　【关键词】剖宫产切口; 瘢痕; 切口妊娠 　　The lower uterine segment cesarean section incision pregnancy clinical treatment experience 　　Jianyang peoples hospital of department of gynaecologyYangyuanZip code: 641400 　　【ABSTRACT】objective to study compared 96 cases of lower uterine segment cesarean section incision pregnancy (CSP) in the clinical treatment. Methods 96 patients with incision pregnancy can be divided into three groups, using different methods for treatment. Average results A, B group, the difference of treatment success of such confinement has no statistical significance (P 0.05), group B 7 d beta HCG blood, vaginal haemorrhage amount decline rate is significantly higher than that of group A, and blood beta HCG turn time significantly less than group A, differences were statistically significant (P 0.05), group C vaginal blood loss and blood beta HCG turn time, average such confinement significantly less than A, B two groups, group C 7 d beta HCG blood drop rate, treatment success rate significantly higher than that of A, B two groups, differences were statistically significant (P 0.05). conclusion Once pregnancy, must take into account the CSP, ultrasonic inspection must be conducted, exclusion of uterine incision pregnancy and the risk factors, such as placenta increta avoid blindly adopt measures to terminate a pregnancy, to reduce the uterine rupture, hemorrhage and other serious complications and reduce the uterus resection. 　　【KEY WORDS】cesarean incision. Scar; Incision pregnancy 　　【中图分类号】R828.2【文献标识码】A 【文章编号】2095-6851（2014）06 剖宫产切口通常选择在子宫下段,产后子宫复旧,子宫下段恢复为子宫峡部,剖宫产瘢痕位于子宫峡部,所谓剖宫产术后切口妊娠是指此部位妊娠。目前公认这类妊娠是特殊类型异