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目的:探讨子宫切口疤痕妊娠的诊治方法,为临床诊治提供可靠依据。方法:对12例子宫切口疤痕妊娠的患者临床资料进行回顾性研究。10例患者联合使用甲氨蝶呤和米非司酮后在超声监测下进行清宫术的保守治疗;2例患者行开腹子宫疤痕切除术和修补术治疗;但有2例患者联合使用甲氨蝶呤和米非司酮后在超声监测下进行清宫术治疗后失败,又立即进行开腹子宫疤痕清除术和修补术治疗。结果:12例子宫切口疤痕妊娠患者均经超声检查及血β-HCG检测确诊。经过上述治疗,12例患者血β-HCG均降至正常范围,子宫得以保留,痊愈出院。且使用甲氨蝶呤和米非司酮后在超声监测下进行清宫术治疗的患者住院时间、住院费用较传统开腹子宫疤痕切除术和修补术治疗患者更为节省,差异有统计学意义(p<0.05)。结论:甲氨蝶呤联合米非司酮治疗后再行清宫术和开腹行子宫疤痕切除术是目前治疗子宫切口疤痕妊娠的有效方法,临床医生应根据患者的具体情况及病情变化正确选择治疗方法。
Objective: To investigate the diagnosis and treatment of uterine incision scar pregnancy, provide a reliable basis for clinical diagnosis and treatment. Methods: The clinical data of 12 cases of uterine incision scar pregnancy were retrospectively studied. Ten patients were treated with methotrexate and mifepristone conservatively undergoing cesarean section. Two patients underwent laparotomy and repair of laparotomy; however, two patients were treated with methotrexate Pterin and mifeprist after the curettage under ultrasound monitoring failed, and immediately open laparoscopic hysterectomy and repair surgery. Results: 12 cases of uterine incision scar pregnancy were confirmed by ultrasound and blood β-HCG test. After the above treatment, 12 patients with blood β-HCG were reduced to the normal range, the uterus was retained, discharged. And the use of methotrexate and mifepristone in patients undergoing uterine surgery under ultrasound monitoring hospitalization costs, hospitalization costs more than the traditional open laparoscopic hysterectomy and repair patients more savings, the difference was statistically significant ( p <0.05). Conclusion: Methotrexate combined with mifepristone treatment after curettage and open line uterine scar resection is the current treatment of uterine incision scar pregnancy an effective method, clinicians should be based on the specific circumstances of patients and the correct choice of treatment change method.