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目的探讨剖宫产切口瘢痕处妊娠的适宜治疗方式。方法回顾性分析我院收治的13例剖宫产切口瘢痕处妊娠患者的临床资料。结果 8例清宫术中大出血,其中5例行子宫次全切除术、3例行子宫切口处瘢痕妊娠组织楔形切除术、1例瘢痕处妊娠破裂急诊开腹手术行子宫次全切除术,3例子宫动脉MTX灌注加栓塞介入治疗后清宫成功、1例肌肉注射MTX后顺利清宫。结论剖宫产切口瘢痕处妊娠突向膀胱或腹腔者不应盲目刮宫、药物流产或引产,对于有强烈的保子宫愿望者,子宫动脉甲氨蝶呤灌注加栓塞介入是治疗子宫瘢痕妊娠的有效方法。
Objective To investigate the appropriate treatment for cesarean section scar pregnancy. Methods The clinical data of 13 pregnant women with cesarean section incision admitted to our hospital were analyzed retrospectively. Results Eight patients underwent radical hysteroscopic surgery. Among them, 5 patients underwent subtotal hysterectomy, 3 underwent wedge resection of uterine incision scar, and 1 underwent open hysterectomy for pregnancy-induced scar. Three cases Uterine artery MTX perfusion and embolization intervention after the success of the Qing Gong, MTL after a successful intramuscular injection of MTX. Conclusion Cesarean section incision scar pregnancy at the bladder or intraperitoneal should not blind curettage, medical abortion or induced abortion, for those who have a strong desire to protect the uterus, uterine artery infusion of methotrexate embolization is effective in treating uterine scar pregnancy method.