摘要
妊娠囊于子宫切口瘢痕部位着床即为剖宫产瘢痕妊娠(CSP),其是剖宫产远期并发症,且属于罕见型异位妊娠。剖宫产瘢痕妊娠的可能机制主要是与剖宫产术后子宫切口愈合不良有关,例如当切口缝合不当时会出现组织修复不全迹象,瘢痕组织局部形成宽大组织缺损。剖宫产术后子宫内膜损伤、血供减少。再次妊娠时受精卵通过穿透剖宫产瘢痕处的微小裂隙并在此处着床,易发生底蜕膜缺损。子宫妊娠处的纤维结缔组织不具有收缩功能,若发生继续妊娠情况,或开展人工流产术则可能导致开放血管无法闭锁,进而诱发大出血情况。CSP的早期诊断可以保证预后效果,以超声或磁共振(MRI)为常用诊断方法,具有较高的疾病检出率。结合诊断结果开展保守治疗或手术治疗能够尽快解除疾病风险,联合围术期护理干预能够保证治疗安全性,减少治疗后相关并发症。基于以上理论,本文综述了CSP的诊治方法与护理措施进展,以期为CSP的临床诊治及护理提供指导。
The implantation of a gestational sac at the scar site of the uterine incision is known as cesarean scar pregnancy(CSP),which is a long-term complication of cesarean section and a rare type of ectopic pregnancy.The possible mechanism of cesarean scar pregnancy is mainly related to poor healing of the uterine incision after cesarean section.For example,when the incision is not sutured properly,there may be signs of incomplete tissue repair,and scar tissue may form large tissue defects locally.Endometrial damage and reduced blood supply after cesarean section.During a second pregnancy,the fertilized egg penetrates the tiny fissures at the scar site of the cesarean section and implants there,which can easily lead to a defect in the basal decidua.The fibrous connective tissue at the site of uterine pregnancy does not have contractile function.If the pregnancy continues or artificial abortion is performed,it may lead to the failure of open blood vessels to close,thereby inducing massive bleeding.Early diagnosis of CSP can ensure prognosis,with ultrasound or magnetic resonance imaging(MRI)being commonly used diagnostic methods and having a high disease detection rate.Conservative or surgical treatment based on diagnostic results can quickly relieve disease risks,and combined with perioperative nursing interventions can ensure treatment safety and reduce related complications after treatment.Based on the above theory,this article reviews the progress of diagnosis and treatment methods and nursing measures for CSP,in order to provide guidance for the clinical diagnosis,treatment,and nursing of CSP.
作者
郑海霞
王磊
刘文静
ZHENG Hai-xia;WANG Lei;LIU Wen-jing(Department of Obstetrics,Tianjin Baodi District People's Hospital,Baodi Clinical College of Tianjin Medical University,Tianjin 301800,China)
出处
《中国城乡企业卫生》
2026年第1期49-53,共5页
Chinese Journal of Urban and Rural Enterprise Hygiene
关键词
剖宫产术
子宫瘢痕部妊娠
诊治方法
护理措施
Cesarean section
Pregnancy in uterine scar
Diagnosis and treatment methods
Nursing measures
