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目的:探讨介入治疗在子宫下段剖宫产后切口瘢痕处妊娠(cesarean scar pregnancy,CSP)的价值。方法:回顾性分析65例CSP患者的诊疗过程,按治疗方案分为直接手术组(A组,n=23)、介入+手术组(B组,n=21)、介入+化疗+手术组(C组,n=8)、化疗+手术组(D组,n=7)和直接化疗组(E组,n=6)。比较各组患者的治疗情况。结果:B、C组患者的胚囊大小、胚芽直径、血流指数、治疗前血β-hCG水平均显著高于其他各组,但手术出血量显著低于其他各组,D组患者的住院天数、住院金额均显著低于B、C组(P<0.05)。结论:针对术前胚囊较大、血流丰富、血β-hCG水平较高的患者,介入+手术治疗子宫下段剖宫产后切口瘢痕处妊娠能显著减少患者出血量,效果良好。
Objective: To investigate the value of interventional treatment for cesarean scar pregnancy (CSP) after cesarean section incision in the lower uterine segment. Methods: The clinical course of 65 patients with CSP were retrospectively analyzed. According to the treatment plan, they were divided into direct operation group (A group, n = 23), interventional + operation group (B group, n = 21) Group C, n = 8), chemotherapy + surgery group (group D, n = 7) and direct chemotherapy group (group E, n = 6). Compare the treatment of each group of patients. Results: The size of embryo sac, diameter of embryo, blood flow index and β-hCG level in blood before and after treatment in group B and C were significantly higher than those in other groups, but the amount of bleeding during operation was significantly lower than that in other groups. Patients in group D were hospitalized Days, hospitalization were significantly lower than the B, C group (P <0.05). Conclusion: For patients with large preoperative embryo sac, rich blood flow, and high level of blood β-hCG, pregnancy can significantly reduce the amount of bleeding after cesarean section incision and interventional surgery, and the effect is good.