CAJ | 학술논문

目的：探讨剖宫产子宫瘢痕处妊娠（CSP）的临床特征及诊治方法。方法回顾性分析该科42例CSP患者的病史、临床表现、诊治经过及结局。结果初诊误诊率达40．4％（17/42），患者均经阴道超声波检查确诊。入院后经保守性治疗25例，其中，12例转腹腔镜手术，1例转开腹手术；首选腹腔镜下手术治疗15例，其中，1例中转开腹；开腹手术1例；介入治疗失败后经开腹行全子宫切除术1例。保守治疗中有3例二次住院，2例二次手术。41例患者成功地保留了子宫，术后平均2个月左右来月经。结论超声波是检查切口厚度的主要方法，腹腔镜是明确诊断和治疗CSP的理想方法。
목적：탐토부궁산자궁반흔처임신（CSP）적림상특정급진치방법。방법회고성분석해과42례CSP환자적병사、림상표현、진치경과급결국。결과초진오진솔체40．4％（17/42），환자균경음도초성파검사학진。입원후경보수성치료25례，기중，12례전복강경수술，1례전개복수술；수선복강경하수술치료15례，기중，1례중전개복；개복수술1례；개입치료실패후경개복행전자궁절제술1례。보수치료중유3례이차주원，2례이차수술。41례환자성공지보류료자궁，술후평균2개월좌우래월경。결론초성파시검사절구후도적주요방법，복강경시명학진단화치료CSP적이상방법。
Objective To investigate the clinical features ,diagnosis and treatment of cesarean scar pregnancy (CSP) .Methods We retrospectively analyzed the medical history ,clinical manifestation ,diagnoses ,treatments and outcomes of 42 patients with ec‐topic pregnancy in the cesarean scar .Results All cases got diagnosed by transvaginal ultrasound .The error rate of first diagnosis was 40 .4% (17/42) .There were 25 cases of conservative therapy ,in which 12 cases were resolved with laparoscopic surgery and 1 case resolved with open surgery ;in the first process 15 cases were carried out laparoscopic surger in which 1 case were converted to laparotomy ;abdominal surgery were underwented in 1 case and were cured .Only one case underwent abdominal total hysterectomy as of failure after uterine artery embolization .After initial conservative treatment 3 cases were hospitalized again and 2 cases under‐went reoperation .41 patients were successfully retained the uterus and normal menstrual cycle returned at two months after opera‐tion .Conclusion The early diagnosis for CSP mainly depended on ultrasound and the thickness of incision muscle layer is an impor‐tant basis for choice of treatment .Checking the thickness of incision muscle layer for CSP mainly depended on ultrasound ,and lapa‐roscopic surgery is an ideal method for diagnosis and treatment of CSP .