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目的:分析剖宫产术后瘢痕部位妊娠(CSP)的临床常用治疗方法。方法:回顾性分析80例CSP患者的病例资料,分析各种治疗方案。结果:甲氨蝶呤治疗1例;米非司酮联合甲氨蝶呤治疗13例;米非司酮+米索前列醇治疗11例;子宫动脉栓塞术的综合治疗7例;米非司酮预处理后予以清宫术20例;米非司酮联合MTX预处理后行清宫术1例;直接清宫术6例;腹腔镜监视下清宫1例;宫腔镜下清宫6例;宫腔镜下病灶电切术3例;经腹疤痕处妊娠物祛除术3例;全子宫切除术2例;米非司酮联合B超引导下局部MTX注射6例。结论:CSP的治疗应根据患者具体情况强调个体化治疗,尽早发现该疾病是改善治疗结局的关键。
Objective: To analyze the common clinical treatment of pregnancy after cesarean section (CSP). Methods: A retrospective analysis of 80 cases of CSP patient data, analysis of various treatment options. Results: Methotrexate treatment in 1 case, mifepristone in combination with methotrexate in 13 cases, mifepristone + misoprostol in 11 cases, uterine arterial embolization in 7 cases, mifepristone Pretreatment after curettage in 20 cases; mifepristone combined with MTX pretreatment after curettage in 1 case; direct curettage in 6 cases; laparoscopic observation of the lower one case of hysteroscopy; hysteroscopy, 6 cases of hysteroscopy; hysteroscopy 3 cases of electrosurgical lesions; 3 cases of abscesses after abdomen scar; 2 cases of total hysterectomy; 6 cases of local MTX injection guided by mifepristone and B-ultrasound. Conclusion: The treatment of CSP should emphasize individualized treatment according to patients’ specific conditions. Early detection of the disease is the key to improving the outcome of treatment.