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目的探讨氨甲喋呤(MTX)联合宫腔镜电切术治疗子宫疤痕妊娠(CSP)的价值。方法回顾性分析厦门市妇幼保健院2007至2012年局部注射MTX联合宫腔镜手术治疗16例子宫疤痕妊娠的治疗方式及预后。结果 16例患者均为Ⅰ型CSP,妊娠物凸向宫腔,入院后口服米非司酮及局部注射MTX后,择期行宫腔镜下病灶电切术。手术时间20~40min,失血量20~150mL,无输血及并发症,均痊愈出院。结论对于Ⅰ型CSP患者,特别是病灶凸向宫腔者,局部注药联合宫腔镜手术治疗安全有效。不仅能达到治愈目的,而且能有效的保留患者的生育功能,缩短住院时间,在有条件的医院值得推广。
Objective To investigate the value of methotrexate (MTX) combined with hysteroscopic electrotomy in the treatment of uterine scar pregnancy (CSP). Methods Retrospective analysis of the treatment and prognosis of 16 cases of uterine scar pregnancy by local injection of MTX combined with hysteroscopic surgery in Xiamen MCH from 2007 to 2012 were retrospectively analyzed. Results All 16 patients were type Ⅰ CSP. The pregnancy was convex to the uterine cavity. After receiving mifepristone and MTX injection, elective hysteroscopic resection was performed. Surgery time 20 ~ 40min, blood loss 20 ~ 150mL, no blood transfusion and complications, were cured and discharged. Conclusion For patients with type Ⅰ CSP, especially those with lesions protruding into the uterine cavity, local injection combined with hysteroscopic surgery is safe and effective. Not only can achieve the purpose of cure, but also effectively retain the patient’s reproductive function, shorten the hospital stay, in the conditional hospital worth promoting.