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目的剖宫产瘢痕妊娠(CSP)治疗方案选取及效果分析。方法选取周口市中医院2006年5月至2015年12月24例剖宫产CSP患者为研究对象,将患者抽签随机分为A、B、C三组,每组8例。A组肌注甲氨蝶呤、口服米非司酮及清宫术治疗,B组给予超声引导下妊娠囊内注射甲氨蝶呤、口服米非司酮及清宫术治疗,C组子宫动脉化疗栓塞术加清宫术治疗,比较三组血β-HCG恢复时间、术后阴道流血时间、孕囊完全萎缩时间、转经时间及清宫术中出血量,手术成功率及并发症发生率。结果 C组血β-HCG恢复时间(36.31±15.20)d、术后阴道流血时间(24.26±9.16)d、孕囊完全萎缩时间(7.39±1.12)d、转经时间(30.96±8.62)d均短于A、B组,清宫术中出血量(30.01±25.13)ml少于A、B组,有统计学意义(P<0.05);B组血β-HCG恢复时间、孕囊完全萎缩时间、转经时间短于A组,有统计学意义(P<0.05);A、B组术后阴道流血时间、清宫术中出血量比较无统计学意义(P>0.05)。结论子宫动脉化疗栓塞术加清宫术治疗剖宫产CSP疗效最好,可促进患者快速恢复,治疗时间短,出血少,且手术成功率较高,并发症发生率低,具有较好的临床应用价值。
Objective Cesarean scar pregnancy (CSP) treatment options and effect analysis. Methods 24 Cesarean section CSP patients from May 2006 to December 2015 in Zhoukou Hospital of Traditional Chinese Medicine were selected as the research objects. Patients were randomly divided into three groups (A, B and C), 8 patients in each group. A group of methotrexate intramuscular, oral mifepristone and curettage, B group given intralesional ultrasound-guided methotrexate injection, oral mifepristone and curettage, C group of uterine artery chemoembolization Surgery and curettage were compared between the three groups of blood β-HCG recovery time, postoperative vaginal bleeding time, gestational sac completely shrinking time, menstrual cycle and curettage bleeding, surgical success rate and complication rate. Results The recovery time of β-HCG in group C (36.31 ± 15.20) d, postoperative vaginal bleeding time (24.26 ± 9.16) d, gestational sac complete collapse time (7.39 ± 1.12) d, (P <0.05). The recovery time of β-HCG in blood serum of group B, the time of full contraction of gestational sac, The transit time was shorter than that in group A (P <0.05). The postoperative vaginal bleeding time in group A and group B was not statistically significant (P> 0.05). Conclusion Uterine arterial chemoembolization and cesarean section have the best curative effect in treating cesarean section CSP, which can promote rapid recovery, short treatment time, less bleeding, high operation success rate, low complication rate and good clinical application value.