国际妇产科学杂志

国际妇产科学杂志 ›› 2011, Vol. 38 ›› Issue (4): 351-353.

• 综述 • 上一篇    下一篇

剖宫产切口瘢痕部位妊娠的研究进展

张国美,糜若然, 杜 雪   

  1. 300300 天津市东丽区医院妇产科(张国美);天津医 科大学总医院妇产科(糜若然,杜雪)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-08-15 发布日期:2011-08-15

Advanced Study of Cesarean Section Scar Pregnancy

ZHANG Guo-mei，MI Ruo-ran，DU Xue   

  1. Department of Obstetrics and Gynecology，Dong Li District Hospital，Tianjin 300300，China（ZHANG Guo-mei）;Department of Obstetrics and Gynecology，General Hospital of Tianjin Medical University，Tianjin 300052，China（MI Ruo-ran，DU Xue）
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-08-15 Online:2011-08-15

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摘要： 剖宫产切口瘢痕部位妊娠（cesarean section scar pregnancy，CSP）是罕见的异位妊娠，是剖宫产远期并发症之一。近年随着剖宫产率的上升，其发病率也在不断攀升。CSP是指妊娠囊种植在原子宫下段剖宫产切口瘢痕部位的妊娠，可发生子宫破裂、大量出血，危及妊娠妇女生命或因此丧失生育能力。高度警惕CSP的发生并应用清晰度较高的B型超声可协助早期诊断。治疗方法包括局部或全身应用甲氨蝶呤（MTX），手术治疗包括单纯性刮宫、腹腔镜、宫腔镜辅助手术、子宫动脉栓塞术以及子宫切除术。应进行综合分析，做出适合于具体患者的治疗措施。如处理得当，预后较好。综述CSP的研究进展。

关键词: 妊娠, 异位, 诊断, 甲氨蝶呤, 腹腔镜, 宫腔镜

Abstract: Cesarean section scar pregnancy（CSP） is a rare but serious complication. The incidence of Cesarean Section is increasing year after year. CSP occurs in women with previous uterine scar when implantation takes place at the site of this scar. CSP is also one of these possible complications that may lead to rupture of the uterus，bleeding and may endanger the woman’s life and even her fertility are at risk. Early diagnosis is possible with high level of suspicion and with the aid of high quality ultrasound scanning. The therapy includes： MTX treatment locally or systematically， dilation and curettage， laparoscopy， Hysteroscopy， uterine artery embolism， and hysterectomy. Different patient needs appropriate treatment. If treated appropriately，the prognosis may be fairly good. Here is a review of the advanced study of CSP.

Key words: Pregnancy, ectopic, Diagnosis, Methotrexate, Laparoscopes, Hysteroscopes