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目的探讨子宫动脉栓塞术联合甲氨蝶呤治疗剖宫产术后子宫瘢痕妊娠(CSP)的临床疗效及安全性。方法回顾性分析63例CSP患者治疗情况,其中44例患者给予甲氨蝶呤肌注治疗(甲氨蝶呤组),19例患者给予子宫动脉栓塞术下子宫动脉内注入甲氨蝶呤治疗(联合治疗组)。结果两组治疗有效率均为100.00%,联合治疗组血β-hCG降至孕前正常水平、妊娠包块消失时间短于甲氨蝶呤组(P<0.05);两组患者治疗期间均存在不同程度的腹痛情况,均在1周左右症状自行缓解。结论子宫动脉栓塞术联合甲氨蝶呤治疗CSP效果显著,手术安全。
Objective To investigate the clinical efficacy and safety of uterine artery embolization combined with methotrexate in the treatment of uterine scar pregnancy (CSP) after cesarean section. Methods A retrospective analysis of 63 patients with CSP treatment, 44 patients were given methotrexate intramuscular injection (methotrexate group), 19 patients were given uterine artery embolization of methotrexate in the treatment of uterine artery ( Combination therapy group). Results The effective rates of both groups were 100.00%. The β-hCG level in the combined treatment group decreased to the normal level before pregnancy, and the disappearance time of the mass in pregnancy was shorter than that in the methotrexate group (P <0.05). There were differences between the two groups in the treatment period Degree of abdominal pain, symptoms are about 1 week to ease themselves. Conclusion Uterine artery embolization combined with methotrexate in the treatment of CSP is significant and safe.