标题：剖宫产后子宫疤痕妊娠绒毛植入14例临床分析

      作者：涂晓贤，冯秀山
    (福建医科大学附属协和医院妇产科，福建 福州 350001)

      卷次： 2013年24卷19期

      【摘要】 目的 探讨剖宫产后子宫疤痕妊娠绒毛植入的诊断和治疗方法。方法 回顾性分析我院2008年3
月至2012年3月收治的14例子宫下段剖宫产子宫切口疤痕妊娠绒毛植入患者的临床资料。结果 12例经彩色
多普勒超声确诊，2例误诊为宫内妊娠、先兆流产，经盆腔磁共振检查后确诊。12例于我院行双侧子宫动脉
栓塞术，栓塞术后 1~3 d行刮宫术，10例治疗成功。1例行次全子宫切除术，1例行人工流产+甲氨蝶呤治疗。
结论 彩超及盆腔磁共振是诊断剖宫产后切口疤痕妊娠绒毛植入的有效方法；子宫动脉栓塞+刮宫术治疗有效，
出血量少，保留生育功能概率高。

      【关键词】 子宫下段剖宫产；疤痕妊娠；绒毛植入

      【中图分类号】 R719.8 【文献标识码】 A 【文章编号】 1003—6350（2013）19—2916—03


Clinical analysis of cesarean scar ectopic pregnancies with villi implanted: fourteen cases reported.
TU
Xiao-xian, FENG Xiu-shan. Department of Obstetrics and Gynecology, Union Hospital Affiliated to Fujian Medical
University, Fuzhou 350000, Fujian, CHINA

【Abstract】 Objective To discuss the diagnosis and management of cesarean scar ectopic pregnancies with
villi implanted. Methods The clinical data of fourteen cesarean scar ectopic pregnancies with villi implanted, from
March 2008 to March 2012 in our hospital, were retrospectively analyzed. Results Twelve patients (78.57%) were
diagnosed by gynecological color Doppler ultrasound examination, and two patients were misdiagnosed as early preg-
nancy, threatened abortion, which was then corrected by pelvic magnetic resonance imaging. Twelve patients under-
went bilateral uterine artery embolization and curettage in one to three days. Ten patients were cured successful, one pa-
tient got subtotal hysterectomy, and another one got artificial abortion with methotrexate therapy. Conclusion Color
Doppler ultrasound and pelvic magnetic resonance are the effective methods for diagnosing cesarean scar ectopic preg-
nancies with villi implanted. Uterine artery embolization and curettage is the effective treatment, which results in less
bleeding and preserves the reproductive function of high rate.

      【Key words】 Uterine lower segmental cesarean section; Cesarean scar pregnancy; Villi implanted