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目的:评价子宫动脉栓塞联合宫腔镜治疗剖宫产瘢痕妊娠的疗效。方法:56例剖宫产瘢痕妊娠患者被分成对照组和实验组:对照组28例采用肌肉注射甲氨蝶呤(MTX)治疗+B超下清宫术,实验组28例行双侧子宫动脉MTX灌注化疗+双侧子宫动脉栓塞,术后宫腔镜下清宫术。结果:实验组28例患者均栓塞成功,23例在栓塞术后48h在宫腔镜下顺利清出妊娠组织,5例清宫后予电凝止血,均手术顺利,术后无严重并发症。较对照组在术中出血、手术时间、住院天数、严重并发症的发生率等方面有显著减少的效果。结论:子宫动脉栓塞联合宫腔镜下清宫术治疗剖宫产瘢痕妊娠是一种微创、安全、有效并值得推广的方法。
Objective: To evaluate the efficacy of uterine artery embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy. Methods: 56 cases of cesarean scar pregnancy were divided into control group and experimental group: 28 cases in the control group were treated with intramuscular methotrexate (MTX) + B-sub-hysteroscopy, 28 cases in the experimental group received bilateral uterine artery MTX Perfusion chemotherapy + bilateral uterine artery embolization, postoperative hysteroscopic curettage. Results: Twenty-eight patients in the experimental group were successfully embolized. Twenty-three hours after the embolization, the pregnant tissue was successfully cleared by hysteroscopy. Five patients were cured by electrocoagulation and the hemostasis was performed successfully. No serious complications occurred after operation. Compared with the control group, there was a significant reduction in intraoperative bleeding, operation time, hospitalization days, the incidence of serious complications and other aspects. Conclusion: Uterine artery embolization combined with hysteroscopic curettage of cesarean scar pregnancy is a minimally invasive, safe, effective and worth promoting method.