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目的探讨剖宫产术后子宫瘢痕部位妊娠(CSP)的诊治。方法分析11例CSP患者临床资料。结果 10例阴道超声确诊,9例行子宫动脉甲氨蝶呤(MTX)灌注栓塞,术后48~72 h清宫治愈;1例行子宫动脉栓塞术(UAE),2次清宫及肌注MTX治愈。1例超声提示宫腔下段妊娠,人流术中大出血,宫腔放置水囊压迫止血治愈。结论阴道超声是可靠的CSP早期诊断方法,子宫动脉MTX灌注栓塞、术后48~72 h行清宫术是CSP有效治疗方法。
Objective To investigate the diagnosis and treatment of uterine scar pregnancy (CSP) after cesarean section. Methods Clinical data of 11 patients with CSP were analyzed. Results 10 cases were diagnosed by vaginal ultrasonography, 9 cases were treated with methotrexate (MTX) embolization of uterine artery and cured by curettage 48 ~ 72 hours after operation. UAE, 2 times of curettage and intramuscular injection of MTX . One case of ultrasound prompted the lower uterine segment of pregnancy, bleeding in abortion, uterine cavity placed hemostasis to cure. Conclusion Vaginal ultrasound is a reliable early diagnosis of CSP, uterine artery embolization with MTX, 48 h to 72 h postoperative curettage is an effective treatment of CSP.