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目的评价剖宫产术后子宫瘢痕处妊娠的处理方式。方法回顾分析2006年1月至2012年2月山东大学齐鲁医院确诊的剖宫产术后子宫瘢痕处妊娠患者102例。分为甲氨蝶呤(MTX)肌内+宫腔注射组(A组)、MTX肌内+宫腔注射+超声引导下清宫组(B组)和子宫动脉灌注化疗栓塞+超声引导吸宫组(C组)。结果 A、B、C3组患者血绒毛膜促性腺激素(β-hCG)恢复至正常时间、瘢痕部位包块消失时间、阴道流血时间、住院时间、住院费用相比较差异有统计学意义(P<0.05)。A、B、C 3组患者治疗成功率分别为92.86%、88.52%、84.62%(P>0.05)。结论 3组方法均可达到较高的治愈率,但MTX肌内+宫腔注射方法简单,花费少,避免侵入性操作。
Objective To evaluate the treatment of uterine scar pregnancy after cesarean section. Methods A total of 102 pregnant women with uterine scar after cesarean section were diagnosed in Qilu Hospital of Shandong University from January 2006 to February 2012 were retrospectively analyzed. MTX intramuscular + intrauterine injection group (group A), MTX intramuscular + intrauterine injection + ultrasonography under the Qing group (group B) and uterine artery infusion chemoembolization + ultrasound-guided suction group (C group). Results The serum hCG levels in group A, B and C3 recovered to normal time, there was no significant difference between the disappearance time of cicatricial mass, vaginal bleeding time, hospitalization time and hospitalization cost (P < 0.05). The success rates of treatment in group A, B and C were 92.86%, 88.52% and 84.62%, respectively (P> 0.05). Conclusion All three methods can achieve a high cure rate, but intramuscular MTX intramuscular injection method is simple, less cost, to avoid invasive operation.