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目的:探讨剖宫产术后子宫瘢痕妊娠(cesarean scar pregnancy,CSP)的临床表现、诊断、治疗及预后。方法:回顾性分析71例CSP患者的临床表现、诊断、治疗及预后的临床资料。结果:71例CSP患者均经阴道彩色超声确诊,其中58例有临床表现。63例行子宫动脉栓塞术(UAE)+甲氨蝶呤(MTX)灌注术,9例行UAE。术后24~48 h,34例B超引导下行清宫术,29例宫腔镜下行清宫术,8例行腹腔镜手术;术后定期监测血人绒毛膜促性腺激素(hCG)至正常。71例均痊愈,月经平均复潮时间40.4±9.0(20~83)d。结论:盆腔彩色超声在CSP诊断中有重要意义,UAE+MTX灌注术+宫腔镜下清宫术(或腹腔镜手术)是治疗CSP的有效方法。
Objective: To investigate the clinical manifestations, diagnosis, treatment and prognosis of cesarean scar pregnancy (CSP) after cesarean section. Methods: A retrospective analysis of 71 cases of CSP patients with clinical manifestations, diagnosis, treatment and prognosis of clinical data. Results: All 71 CSP patients were confirmed by vaginal color ultrasound, of which 58 cases had clinical manifestations. 63 patients underwent uterine artery embolization (UAE) + methotrexate (MTX) perfusion, and 9 patients underwent UAE. From 24 to 48 hours after surgery, 34 cases underwent B-guided ultrasonography, 29 underwent hysteroscopic curettage, and 8 underwent laparoscopic surgery. Blood hCG was monitored regularly after surgery. 71 cases were cured, the average menstruation time 40.4 ± 9.0 (20 ~ 83) d. CONCLUSION: Color Doppler ultrasound is of great importance in the diagnosis of CSP. UAE + MTX perfusion and hysteroscopic (or laparoscopic) surgery are effective methods for the treatment of CSP.