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目的探讨低流量低剂量甲氨蝶呤(MTX)动脉灌注栓塞术在终止剖宫产术后子宫瘢痕妊娠(CSP)中的应用价值。方法对诊断明确的83例CSP患者行DSA血管造影、低流量低剂量MTX子宫动脉灌注加栓塞术,术后在宫腔镜下行清宫术,对疗效及出血量及月经恢复时间进行分析。结果 83例CSP的患者行低流量动脉灌注加栓塞术后,均在3~5天内行清宫术,恢复良好,术中出血量均<20 ml,平均出血量约(11.3±2.14)ml,清宫术前血β-HCG下降明显,术后β-HCG平均恢复正常时间为(22±3.86)天,术后平均月经恢复时间为(52±6.53)天。结论低流量低剂量MTX动脉灌注栓塞术在终止CSP应用中,能明显减少MTX用量,血β-HCG值下降明显,恢复正常值时间缩短,减少清宫术中组织损伤及术中出血,月经恢复时间缩短,是一种安全、有效的治疗方法。
Objective To investigate the value of low dose and low dose methotrexate (MTX) arterial infusion and embolization in the termination of cesarean section after uterine scar pregnancy (CSP). Methods Eighty-three CSP patients underwent DSA angiography and low-dose and low-dose MTX uterine arterial infusion and embolization. The patients underwent hysteroscopic surgery under hysteroscopy. The curative effect, blood loss and menstruation recovery time were analyzed. Results 83 cases of CSP patients underwent low-flow arterial infusion and embolization, were cured within 3 to 5 days curettage, recovery was good, the amount of bleeding were less than 20 ml, the average bleeding (11.3 ± 2.14) ml, the Qing Palace The preoperative serum β-HCG decreased significantly, and the mean postoperative β-HCG recovery time was (22 ± 3.86) days. The mean postoperative menstrual recovery time was (52 ± 6.53) days. Conclusions Low dose and low dose MTX arterial perfusion and embolization can significantly reduce the amount of MTX during the termination of CSP application, the blood β-HCG decreased significantly, the time to return to normal value was shortened, and the tissue damage and intraoperative bleeding, menstruation recovery time Shorten, is a safe and effective treatment.