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目的:探讨子宫动脉栓塞联合宫腔镜治疗剖宫产瘢痕妊娠的临床效果。方法:选择我院2010年3月~2013年6月收治的68例剖宫产瘢痕妊娠患者,随机分为观察组和对照组,各34例。对照组给予肌肉注射甲氨蝶呤(MTX)及B超下清宫术,实验组给予双侧子宫动脉栓塞+MTX灌注化疗,双侧子宫动脉栓塞术后宫腔镜下清宫术。结果:对照组34例中,一次清宫成功24例,并发症发生率为11.76%,观察组34例均一次清宫成功,并发症发生率为0(P<0.05)。观察组手术时间、术中出血量、阴道出血量、阴道出血持续时间、子宫穿孔和住院天数均小于对照组,但住院费用高于对照组,差异有统计学意义(P<0.05)。结论:子宫动脉栓塞联合宫腔镜治疗剖宫产瘢痕妊娠成功率高,可缩短住院时间,并发症少,安全可靠,值得推广。
Objective: To investigate the clinical effect of uterine artery embolization combined with hysteroscopy in cesarean scar pregnancy. Methods: Sixty-eight patients with cesarean scar pregnancy treated in our hospital from March 2010 to June 2013 were randomly divided into observation group and control group, with 34 cases in each group. The control group was given intramuscular methotrexate (MTX) and B-sub-hysteroscopy, the experimental group was given bilateral uterine artery embolization + MTX perfusion chemotherapy, hysteroscopic hysteroscopic surgery after bilateral uterine artery embolization. Results: Among the 34 cases in the control group, 24 cases were successful in the curettage and the complication rate was 11.76%. All the 34 cases in the observation group were successful in the curettage and the complication rate was 0 (P <0.05). The operation time, intraoperative blood loss, vaginal bleeding volume, vaginal bleeding duration, uterine perforation and hospitalization days in the observation group were all less than those in the control group, but the hospitalization expenses were higher than those in the control group (P <0.05). Conclusion: The success rate of uterine artery embolization combined with hysteroscopy in cesarean scar pregnancy is high, which can shorten the length of hospital stay, reduce complications, be safe and reliable, and worthy of promotion.