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目的:探讨基层医院对子宫下段切口妊娠的诊断与处理。方法:回顾分析我院于2010年11月～2011年11月诊治的剖宫产术后子宫切口妊娠的3例患者的临床资料。结果:1例经彩色多普勒超声检查结合血β-HCG、临床表现,首诊确诊,经药物保守治疗成功;2例误诊,人工流产术中因出血多,转诊上级医院诊治。结论:基层医院由于条件设施限制,容易误诊相关病例。对于要求终止妊娠的患者有剖宫产术史的,彩色多普勒检查尤为重要。注意妊娠孕囊与子宫切口疤痕之间的位置关系,结合学β-HCG及临床症状,以及时确诊,予MTX合并米非司酮药物保守治疗,或及时转诊上级医院行介入化疗、子宫动脉栓塞等相关治疗。
Objective: To explore the diagnosis and treatment of pregnancy in lower uterine incision in primary hospital. Methods: A retrospective analysis of our hospital in November 2010 ~ November 2011 diagnosis and treatment of cesarean section after uterine incision pregnancy in 3 patients with clinical data. Results: One case was diagnosed by color Doppler ultrasonography combined with blood β-HCG. The first clinical diagnosis was confirmed by conservative treatment. Two cases were misdiagnosed and induced abortion due to excessive bleeding. Conclusion: The grass-roots hospitals due to conditions and facilities constraints, easily misdiagnosed cases. Color Doppler exams are particularly important for patients who require cesarean delivery for termination of pregnancy. Pay attention to pregnancy gestational sac and uterine incision scars between the location of the combination of β-HCG and clinical symptoms, and timely diagnosis, to MTX with mifepristone conservative treatment, or timely referral to higher-level hospital interventional chemotherapy, uterine artery Embolism and other related treatment.