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目的探讨不同途径治疗剖宫产术后子宫瘢痕妊娠(CSP)的临床疗效。方法回顾性分析2011年1月-2012年12月厦门大学附属第一医院妇产科收治的CSP患者21例为研究对象。采用甲氨喋呤(MTX)+米非司酮和/或超声监测下清宫术,子宫动脉栓塞术(UAE)和/或超声监测下清宫术,妊娠病灶切除术+子宫瘢痕修补术治疗CSP,比较不同途径治疗CSP的临床疗效。结果 10例患者予MTX+米非司酮/+清宫术,9例患者行UAE+清宫术,2例患者行妊娠病灶切除术。结论 CSP呈上升趋势,治疗方式应采取个体化的原则。MTX+米非司酮+清宫术、UAE+清宫术,是安全有效的CSP治疗方法,积极行妊娠病灶切除可缩短治疗周期,疗效确切。
Objective To investigate the clinical effects of different ways of treating uterine scar pregnancy (CSP) after cesarean section. Methods A retrospective analysis of 21 patients with CSP admitted to the Obstetrics and Gynecology Center of the First Affiliated Hospital of Xiamen University from January 2011 to December 2012 was performed. Treatment of CSP with methotrexate (MTX) + mifepristone and / or under uterine curettage, uterine arterial embolization (UAE) and / or ultrasonography under hysteroscopy, pregnancy excision + uterine scar repair, Compare different ways to treat CSP. Results 10 patients were treated with MTX + mifepristone / + curettage, 9 patients underwent UAE + curettage, and 2 patients underwent resection of pregnancy. Conclusion CSP is on the rise and treatment should be individualized. MTX + mifepristone + curettage, UAE + curettage, is a safe and effective CSP treatment, aggressive pregnancy removal of the lesion can shorten the treatment cycle, the exact effect.