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目的探讨剖宫产瘢痕妊娠(CSP)的临床诊断及治疗方法。方法回顾性分析2008年7月-2014年7月收治的CSP患者29例的临床资料。结果 14例行子宫动脉栓塞加灌注化疗及清宫术;4例在B超引导下行清宫术治疗,其中1例行清宫术中因子宫大出血而中转开腹行病灶切除术;5例在超声监护下经宫腔镜CSP病灶切除术;1例在腹腔镜监护下经宫腔镜CSP病灶切除术;2例行腹式CSP病灶局部切除术;1例行腹腔镜下CSP病灶清除术;1例入院时已发生子宫破裂行腹式全子宫切除术;1例行超声引导下局部病灶注射甲氨蝶呤+米非司酮口服治疗;随访血β-人绒毛促性腺激素(human chorionic gonadotrophin,hCG)均降至正常。结论早期及时诊断CSP,采取个体化治疗,以保留患者的生育功能。
Objective To investigate the clinical diagnosis and treatment of cesarean scar pregnancy (CSP). Methods The clinical data of 29 patients with CSP admitted from July 2008 to July 2014 were retrospectively analyzed. Results 14 cases of uterine artery embolization plus chemotherapy and curettage; 4 cases underwent B-guided radical curettage, including 1 case of uterine bleeding due to uterine curettage and laparotomy in the radical resection; 5 cases under ultrasound monitoring Hysteroscopic CSP resection; 1 case underwent laparoscopic hysteroscopic CSP resection; 2 cases underwent abdominal CSP focal excision; 1 case underwent laparoscopic CSP debridement; 1 case was admitted Uterine rupture occurred abdominal hysterectomy; 1 case of ultrasound-guided local lesion injection of methotrexate + mifepristone oral treatment; follow-up of blood β-human chorionic gonadotrophin (hCG) All fell to normal. Conclusion Early diagnosis of CSP in time, to individualized treatment to retain the patient’s reproductive function.