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目的分析剖宫产后子宫瘢痕处妊娠(CSP)的处理。方法回顾性分析40例CSP患者的不同方法处理效果。结果 40例患者中,14例行米非司酮+甲氨蝶呤(MTX)灌注+子宫动脉栓塞术(UAE)+择期清宫术,20例行MTX联合米非司酮药物治疗(7例单纯药物治疗,13例药物后联合清宫术),2例实施阴式或开腹瘢痕出妊娠病灶切除术+瘢痕缺陷修复术,2例患者因子宫破裂、2例在药物保守治疗后实施子宫切除术。40例患者均治愈。结论剖宫产后子宫瘢痕处妊娠治疗时应根据具体情况而选择针对性的治疗方案,其中应用最广泛的治疗方法为米非司酮+MTX灌注+UAE+择期清宫术,应用安全可靠,效果显著。
Objective To analyze the treatment of pregnancy (CSP) at uterine scar after cesarean section. Methods Retrospective analysis of 40 cases of CSP treatment of different methods. Results Of the 40 patients, 14 patients underwent mifepristone + methotrexate (MTX) perfusion + Uterine artery embolization (UAE) + elective cesarean section, and 20 patients underwent MTX plus mifepristone treatment Drug treatment, combined with 13 patients after curettage), 2 cases of vaginal incision or open scar excision of pregnancy + scar defect repair, 2 patients with uterine rupture, 2 patients after conservative treatment of hysterectomy . 40 patients were cured. Conclusion Cesarean section uterine scar pregnancy treatment should be based on the specific circumstances and select the appropriate treatment options, including the most widely used treatment for mifepristone + MTX perfusion + UAE + elective curettage, the application of safe and reliable, the effect is significant .