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目的探讨比较单纯肌肉注射甲氨蝶呤、胚囊绞杀+注射甲氨蝶呤以及子宫动脉化学疗法(化疗)栓塞术3种方法治疗后进行清宫术治疗剖宫产瘢痕部位妊娠(CSP)的临床疗效。方法回顾性分析2009年1月-2013年12月住院的208例CSP患者治疗前后的临床资料,分为3组:A组72例,采用单纯肌肉注射甲氨蝶呤,B组70例,采用胚囊绞杀+注射甲氨蝶呤,C组66例,采用子宫动脉化疗栓塞术。比较3组患者术前治疗时间间隔、住院时间、清宫术中出血、血β-人绒毛膜促性腺激素(血β-HCG)下降至正常所需时间、住院费用、转经时间的差异。结果进行C组患者术后清宫的术前治疗时间间隔、住院时间、清宫术中出血、血β-HCG下降至正常时间、转经时间,均优于A组、B组,差异有统计学意义(P<0.05);3组住院费用差异无统计学意义(P>0.05)。结论子宫动脉化疗栓塞术治疗CSP,具有住院时间短、大出血风险低、患者生育功能易保留、安全、疗效确切的优点,值得临床推广应用。
Objective To investigate the effect of cesarean section in the treatment of cesarean scar pregnancy (CSP) after three treatments of simple intramuscular methotrexate, embryo-blastocyst + methotrexate injection and uterine artery chemotherapy (chemotherapy) embolization Efficacy. Methods The clinical data of 208 CSP patients hospitalized from January 2009 to December 2013 were retrospectively analyzed. The data were divided into three groups: group A, 72 cases, simple intramuscular methotrexate, group B, 70 cases, Stomach blastotomy + methotrexate injection, C group of 66 cases, the use of uterine artery chemoembolization. The differences of preoperative treatment time, hospitalization time, hemorrhage during the operation of curettage, blood β-human chorionic gonadotropin (blood β-HCG) time to normal, hospitalization cost and menstrual cycle time were compared between the three groups. Results The preoperative treatment interval, hospital stay, postoperative curettage bleeding, serum β-HCG decreased to normal time and transit time in group C were better than group A and group B, the difference was statistically significant (P <0.05). There was no significant difference in hospitalization costs between the three groups (P> 0.05). Conclusion Uterine arterial chemoembolization for the treatment of CSP has the advantages of short hospital stay, low risk of bleeding, easy retention of patients’ fertility, safe and effective curative effect, which is worthy of clinical application.