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目的探讨氨甲喋呤加平阳霉素碘油乳剂介入治疗高风险子宫切口疤痕妊娠(CSP)的疗效和安全性。方法选取临床确诊CSP且孕囊位于肌层向外生长、供血丰富、原始胚胎生长活性程度高的高风险者51例,使用氨甲喋呤+平阳霉素碘油乳剂行子宫动脉化疗栓塞术(UACE)治疗,术后观察患者副反应、并发症、临床效果。结果全部病例UACE治疗1次成功,并保留住子宫,术后副反应少、轻,无治疗相关并发症,临床跟踪观察4例和病理检查47例证实全部杀死胚胎,无大出血发生。结论使用氨甲喋呤+平阳霉素碘油乳剂行UACE治疗高风险CSP临床效果好、安全性高。
Objective To investigate the efficacy and safety of methotrexate plus pingyangmycin lipiodol emulsion in the treatment of high-risk incisional scar pregnancy (CSP). Methods Totally 51 high-risk patients with clinically diagnosed CSP and gestational sac located in the muscular layer, rich in blood supply and high original embryo growth activity were treated with methotrexate and bleomycin lipiodol emulsion in patients undergoing uterine artery chemoembolization (UACE) Postoperative patients were observed side effects, complications, clinical effects. Results All the cases were successfully treated with UACE for one time and retained the uterus. There were fewer postoperative side effects, mild and no complications related to treatment. Clinical follow-up observation of 4 cases and pathological examination of 47 cases confirmed that all the embryos were killed without major hemorrhage. Conclusion Methotrexate + Pingyangmycin lipiodol emulsion UACE in the treatment of high-risk CSP good clinical effect, high safety.