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目的:探讨剖宫产瘢痕部位妊娠(CSP)个性化的治疗方案。方法:回顾性分析2006年-2012年间武汉市新洲区人民医院21例CSP患者的临床资料,根据患者的孕周、β人绒毛膜促性腺激素(β-HCG)峰值及超声检查结果,行氨甲喋呤(MTX)全身用药,MTX全身用药+局部注射MTX疗法及手术治疗3种方案,分析MTX在此类患者中的治疗价值及影响MTX治疗效果的因素。结果:21例CSP患者中MTX保守治疗成功率分别为72.7%(8/11)及57.1%(4/7)。9例手术治疗,其中2例行全宫切除术。结论:MTX在CSP患者中的治疗效果值得肯定。但无论是哪种治疗方案,均有可能发生严重大出血及子宫破裂的风险。
Objective: To explore the cesarean scar pregnancy site (CSP) personalized treatment. Methods: The clinical data of 21 CSP patients from 2006 to 2012 in Xinzhou District People’s Hospital of Wuhan were retrospectively analyzed. According to the gestational age, the peak of β-HCG and the results of ultrasonography, Methotrexate (MTX) systemic therapy, MTX systemic therapy + local injection of MTX therapy and surgical treatment of three kinds of programs, analysis of MTX in patients with such treatment and the impact of MTX treatment factors. Results: The success rates of conservative treatment of MTX in 21 CSP patients were 72.7% (8/11) and 57.1% (4/7), respectively. Surgical treatment was performed in 9 cases, of which 2 cases underwent hysterectomy. Conclusions: The efficacy of MTX in CSP patients is worthy of recognition. But no matter what kind of treatment options, are likely to have a serious risk of bleeding and uterine rupture.