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目的:探讨剖宫产瘢痕妊娠的发病机制、诊断、治疗方法。方法:对9例剖宫产瘢痕妊娠患者的治疗方式及转归进行回顾分析。结果:9例中有8例为早-中期剖宫产瘢痕妊娠患者,其中5例成功采用血管介入栓塞治疗,3例行甲氨蝶呤(MTX)肌肉注射化疗失败,后转开腹行子宫瘢痕病灶切除;1例为晚孕患者,因产前出血行急诊剖宫产术,术时大量出血、失血性休克而予子宫切除,母子抢救成功。本组无一例死亡。结论:对孕早-中期子宫瘢痕妊娠患者血管介入栓塞治疗效果可靠,可作为首选治疗方法;采用清宫术将瘢痕处妊娠组织及淤血清除不是必须的,可根据患者入院时的病情和个人要求,尽早选择合理治疗方式,及时终止妊娠。
Objective: To investigate the pathogenesis, diagnosis and treatment of cesarean scar pregnancy. Methods: Nine patients with cesarean scar pregnancy were analyzed retrospectively. RESULTS: Eight of the nine patients had early-to-mid-term cesarean scar pregnancy, of whom 5 were successfully treated with vascular embolization and 3 received MTX intramuscular chemotherapy and failed to switch to the open uterus Scar lesions removed; 1 case of late pregnancy, emergency cesarean section due to prenatal hemorrhage, a large number of bleeding during surgery, hemorrhagic shock and hysterectomy, mother and child rescue success. No one died in this group. Conclusion: It is reliable to treat the patients with uterine cesarean pregnancy in the first trimester of pregnancy, and can be used as the preferred method of treatment. Clearing the pregnancy tissue and congestion of the scar is not necessary. According to the patient’s condition and personal requirements, Choose a reasonable early treatment, timely termination of pregnancy.