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目的:探讨子宫动脉栓塞联合氨甲喋呤治疗子宫瘢痕部位妊娠的应用价值。方法:回顾分析本院自2009年7月~2012年6月子宫动脉栓塞联合氨甲喋呤治疗的18例剖宫产子宫瘢痕部位妊娠的病例资料。结果:18例治疗均成功,术后阴道流血停止,孕囊明显缩小,血清人绒毛膜促性腺激素明显下降。术后清宫无大出血,病理检查示子宫瘢痕部位绒毛、蜕膜或胎盘组织,有变性、坏死。结论:子宫动脉介入联合氨甲喋呤治疗子宫瘢痕部位妊娠,能有效预防和控制出血,减小清宫危险,并保留子宫,是子宫瘢痕部位妊娠安全、有效的治疗方法之一。
Objective: To investigate the value of uterine artery embolization combined with methotrexate in the treatment of uterine scar site pregnancy. Methods: A retrospective analysis of our hospital since July 2009 ~ June 2012 Uterine artery embolization combined with methotrexate 18 cases of cesarean section uterine scar pregnancy data. Results: All of the 18 cases were successfully treated. The postoperative vaginal bleeding stopped, the gestational sac was significantly reduced and the serum human chorionic gonadotropin was significantly decreased. No major bleeding after surgery, pathological examination showed uterine scar site villi, decidua or placental tissue, degeneration and necrosis. Conclusion: Uterine artery intervention combined with methotrexate in the treatment of uterine scar site pregnancy, can effectively prevent and control bleeding, reduce the risk of clearance, and retain the uterus, uterine scar pregnancy is one of the safe and effective treatment.