剖宫产瘢痕部位妊娠的治疗方法探讨

摘要

目的：探讨剖宫产瘢痕部位妊娠（CSP）发生的高危因素及治疗方法。方法回顾性分析78例CSP 患者的临床资料，分析各种治疗方案。结果甲氨蝶呤治疗11例；米非司酮联合甲氨蝶呤治疗4例；米非司酮治疗4例；子宫动脉栓塞术的综合治疗40例；药物预处理后予以清宫术5例；直接清宫术1例；经腹疤痕处妊娠物祛除术7例；全子宫切除术1例；其他5例。结论CSP 的治疗应根据患者具体情况个体化治疗。介入＋清宫术治疗是一种较安全、有效的方法，术中出血少，术后住院时间短，值得临床推广。%Objective To explore the high risk factors and treatment of cesarean scar pregnancy (CSP). Methods The clinical data of 78 cases with CSP were analyzed retrospectively,and analyzed the plan of treatment.Re-sults Eleven patients were treated with methotrexate,4 patients had received mifepristone combined with methotrexate, 4 patients were treated with mifepristone,40 patients were treated with the comprehensive treatment of uterine artery em-bolization (UAE),5 patients were performed with ultrasound -guided curettage after medicine preconditioning,one pa-tient was performed with ultrasound -guided curettage,7 patients were performed with pregnancy tissue dispel form scar by transabdominal,one patient was performed with hysterectomy,5 patients were treated with other methods.Conclusions The patients of CRS should be treated individually according to the condition of patients.Interventional therapy com-bined with complete curettage of uterine cavity is a safe and effective method with less amount of blood loss and short-ened hospital stay.