超声引导下局部注射氨甲蝶呤治疗剖宫产术后瘢痕妊娠

摘要

Objective To explore the value of ultrasound-guided methotrexate local injection for the treatment of cesarean scar pregnancy (CSP).Methods The clinical data and ultrasonographical characteristics of 17 CSP patients who received the treatment of ultrasound-guided methotrexate local injection were retrospectively analyzed.The treatment outcomes and the recovery time of serum β-HCG value were recorded.Results Thirteen of 17 cases achieved successful treatment.Ten of them were gestational sactype with a average diameter of gestional sac below 2.0 cm.The other 3 cases were mass type with average diameters of 2.8 cm,3.0 cm and 3.3 cm.The recovery time of serum β-HCG value was within 13～41 d.The treatment failed in 4 cases.One of them was gestation sac type and the average diameter was 2.6 cm.The other 3 cases was mass type and the average diameter was larger than 3.5 cm.Conclusion Ultrasound-guided methotrexate local injection is a minimally invasive,simple and effective method for the CSP treatment.%目的 探讨超声引导下局部注射氨甲蝶呤治疗剖宫产术后瘢痕妊娠(CSP)的价值.方法 回顾性分析17例接受超声引导下局部注射氨甲蝶呤治疗的CSP患者的临床资料和声像图特点,记录治疗结局、血清人绒毛膜促性腺激素(β-HCG)恢复正常的时间.结果 17例接受治疗的CSP患者中13例治疗成功,其中10例为孕囊型,孕囊平均径≤2.0 cm；3例为包块型,包块平均径分别为2.8,3.0,3.3 cm,血清β-HCG恢复至正常值的时间为13～41 d.4例治疗失败,其中l例为孕囊型,孕囊平均径为2.6 cm;3例为包块型,包块平均径＞3.5 cm.结论 超声引导下局部注射氨甲蝶呤治疗CSP是一种微创、简便、有效的方法.