剖宫产术后子宫瘢痕部位妊娠30例临床分析

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目的:探讨剖宫产术后子宫瘢痕部位妊娠(CSP)的治疗方法。方法回顾性分析我院2011年12月~2015年6月我院收治的30例CSP患者的治疗情况。采用子宫动脉栓塞术(UAE)和(或)清宫术,甲氨蝶呤(MTX)或米索前列醇+米非司酮药物治疗+清宫术,子宫全切除术治疗CSP,比较3种术式治疗CSP的临床疗效。结果 UAE+清宫术治疗,药物保守治疗+清宫术的住院时间分别为(10.50±1.56)d,(24.53±3.25)d,组间比较,差异具有统计学意义(=0.015);血β-HCG降至正常时间分别为(20.93±2.20)d,(42.13±3.25)d,组间比较,差异具有统计学意义(=0.048);随访时间分别为(66.53±3.89)d,(149.71±6.26)d,组间比较,差异具有统计学意义(=0.032);1例患者行子宫次全切除术。结论 CSP早期明确诊断是关键,经阴道彩色多普勒B超是诊断CSP的首选方法,CSP治疗方法多样,对确诊病例采取个体化治疗。“,”Objective To study the treatment methods for cesarean scar pregnancy (CSP). Methods A retrospective analysis of the treatments for 30 CSP patients admitted to our hospital between December 2011 and June 2015. The operation methods included three kinds of operation methods, uterine arterial embolism (UAE)/+ curettage of uterine ,MTX or misoprostol and Mifepristone/+ curettage of uterine, and hysterectomy.Results The duration of hospitalization of two kinds of operation methods (uterine arterial embolism (UAE)/+ curettage of uterine ,MTX or misoprostol and Mifepristone/+ curettage of uterine) were (10.50±1.56)d,(24.53±3.25)d, respectively, with significant differences ( =0.015).The time of blood B-hCG level back to normal were (20.93±2.20)d,(42.13±3.25)d,respectively,with significant differences ( =0.048).The follow-up time of two kinds of operation methods were (66.53±3.89)d,(149.71±6.26)d,respectively,with significant differences ( =0.032).and 1 case with uterus total resection.-. All were successful. Conclusion Early diagnosis is the key to CSP treatment. Transvaginal color Doppler ultrasound is the first choice for diagnosis of CSP. CSP treatment methods varies toindividuals.
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