孕囊内注射MTX联合宫腔镜治疗子宫瘢痕妊娠62例临床分析

目的探讨孕囊内注射MTX联合宫腔镜治疗子宫瘢痕妊娠的临床价值。方法回顾性分析2006年1月～2012年12月我院62例孕囊内注射MTX联合官腔镜治疗的子宫瘢痕妊娠的临床资料。结果62例患者均为1型子宫瘢痕妊娠，彩超均为活胚。囊内注射MTX前血B—HCG（9590±1230）mlU／mL，注射后4d血β-HCG下降（87．5±11．8）％，1周血β-HCG下降（93．5±12．3）％。孕囊死亡平均时间为3～8d。官腔镜术中无子宫穿孔、子宫破裂、大出血发生。结论孕囊内注射MTX联合官腔镜治疗孕囊向宫内生长、活胚的I型子宫瘢痕妊娠具有疗效好、治疗周期短、血B—HCG恢复快、创伤小、出血少的特点，是安全、有效的治疗方法。

Clinical analysis of gestation sac injection of MTX combined with hystero- scopic treated on 62 cases of cesarean scar pregnancy

Objective To evaluate the clinical effect of gestation sac injection of MTX combined hysteroscopic treat- ment with cesarean scar pregnancy. Methods The clinical data of 62 cases in gestation sac injection of MTX combined hysteroscopic treatment with cesarean scar pregnancy from the hospital from January 2006 to December 2012 were an- alyzed retrospectively. Results All 62 patients were I type of cesarean scar pregnancy, color ultrasound showed that all the embryo sac were living. The β-HCG was （9 590±1 230）mIU/mL before gestation sac injection of MTX. The B- HCG decreased by （87.5±11.8）% after four days, the β-HCG decreased by （93.5±12.3）% after a week. The average time of embryonic death was 3 to 8 days. No perforation of uterus and uterine rupture and bleeding in hysteroscopy surgery. Conclusion Gestation sac injection of MTX combined hysteroscopic treatment of the cesarean scar pregnancy, especially living embryos, I type of cesarean scar pregnancy has the characteristics of good treatment result and short treatment period, β-HCG recovered quickly, small trauma, less bleeding, was safe and effective treatment method.