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目的:分析不同治疗方法对剖宫产瘢痕妊娠的治疗效果。方法:回顾性分析49例剖宫产瘢痕妊娠患者的临床资料,根据不同治疗方法分组。子宫动脉栓塞联合甲氨蝶呤局部用药及择期行宫腔镜下病灶切除术20例为A组,宫腔镜下病灶切除术11例为B组,药物杀胚联合宫腔镜下病灶切除术10例为C组,开腹病灶切除术8例为D组,比较4组患者的治疗成功率、子宫切除率、手术时间、术中出血量、输血量、术后住院时间、治疗费用情况等。结果:A组患者的手术时间、术中出血量、术后住院时间、治疗费用情况与B、C、D组比较差异均有统计学意义(P<0.05),A、B、C组患者的输血量与D组比较差异有统计学意义(P<0.05)。结论:子宫动脉栓塞联合甲氨蝶呤局部用药以及择期行宫腔镜下病灶切除术治疗效果好、安全性高,是治疗剖宫产瘢痕妊娠理想治疗方法。
Objective: To analyze the curative effect of different treatment methods on cesarean scar pregnancy. Methods: A retrospective analysis of 49 cases of cesarean scar pregnancy in patients with clinical data, grouped according to different treatment methods. Uterine artery embolization combined with methotrexate local administration and elective hysteroscopic resection in 20 cases for group A, hysteroscopic resection in 11 cases for the B group, the drug kill embryo combined with hysteroscopic resection 10 Cases of C group, open excision of the tumor in 8 cases for the D group, compared the treatment success rate of 4 patients, hysterectomy rate, operation time, intraoperative blood loss, blood transfusion, postoperative hospitalization, treatment costs and so on. Results: The operation time, intraoperative blood loss, postoperative hospital stay and treatment cost in group A were significantly different from those in groups B, C and D (P <0.05), while those in groups A, B and C Blood transfusion and D group had significant difference (P <0.05). Conclusion: Uterine artery embolization combined with topical methotrexate and elective hysteroscopic resection of the hysterectomy is effective and safe, it is the ideal treatment for cesarean scar pregnancy.