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目的探讨剖宫产术后瘢痕部位妊娠(CSP)的治疗方法。方法选取我院2014年1月~2016年7月收治的CSP患者60例为研究对象,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的治疗疗效。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)天,(24.53±3.25)天,组间比较,差异有统计学意义(P<0.05);血β-HCG降至正常时间分别为(20.93±2.20)天,(42.13±3.25)天,组间比较,差异有统计学意义(P<0.005);随访时间分别为(66.53±3.89)天,(149.71±6.26)天,组间比较,差异有统计学意义(P<0.05);2例患者行子宫次全切除术。结论 CSP早期明确诊断是关键,经阴道多普勒彩超是诊断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 investigate the treatment of cesarean section scar pregnancy (CSP). Methods Sixty patients with CSP admitted to our hospital from January 2014 to July 2016 were enrolled in this study. Uterine arterial embolization (UAE) and / or cesarean section, methotrexate (MTX) or misoprostol + Mifepristone drug therapy + curettage, total hysterectomy for CSP, compared three kinds of surgical treatment of CSP efficacy. Results The hospitalization time of UAE + curettage and conservative cure + curettage was (10.50 ± 1.56) days and (24.53 ± 3.25) days, respectively. The difference was statistically significant (P <0.05) (20.93 ± 2.20) days and (42.13 ± 3.25) days, respectively. The differences between the two groups were statistically significant (P <0.005). The follow-up time was (66.53 ± 3.89) days and (149.71 ± 6.26) days respectively ) Day, the difference between the two groups was statistically significant (P <0.05); 2 cases underwent subtotal hysterectomy. Conclusion The early diagnosis of CSP is the key. Transvaginal Doppler ultrasonography is the first choice for CSP diagnosis. CSP has various treatment methods and individualized treatment of the confirmed cases.