不同途径治疗剖宫产术后子宫瘢痕妊娠的临床疗效分析

目的探讨不同途径治疗剖宫产术后子宫瘢痕妊娠（CSP）的临床疗效。方法回顾性分析2011年1月-2012年12月厦门大学附属第一医院妇产科收治的CSP患者21例为研究对象。采用甲氨喋呤（MTX）＋米非司酮和／或超声监测下清宫术，子宫动脉栓塞术（UAE）和／或超声监测下清宫术，妊娠病灶切除术＋子宫瘢痕修补术治疗CSP，比较不同途径治疗CSP的临床疗效。结果10例患者予MTX＋米非司酮／＋清宫术，9例患者行uAE＋清宫术，2例患者行妊娠病灶切除术。结论CSP呈上升趋势，治疗方式应采取个体化的原则。MTX＋米非司酮＋清宫术、uAE＋清宫术，是安全有效的CSP治疗方法，积极行妊娠病灶切除可缩短治疗周期，疗效确切。

Analysis of clinical effects of different treatments for cesarean scar pregnancy

Objective ] To discuss the clinical effects of different ways for cesarean scar pregnancy （CSP） . Methods J From January 2011 to December 2012 , 21 cases with CSP in the department of gynaecology and obstetrics of First Affiliated Hospital of Xiamen University were reviewed retrospectively. Using methotrexate （MTX） ＋ mifepristone and （or） ultrasound-guided curettage, uterine artery embolization （UAE） and （or） ultrasound-guided curettage, pregnancy lesion resection and uterine scar repairtion in the treatment of CSP, the clinical curative effect of different approaches were compared with the treatment of CSP. Resluts ] 10 patients were treated with MTX ＋ mifepristone and uterine curettage, 9 cases with UAE＋ uterine curettage, 2 cases of patients with pregnancy lesion resection. Conclusions ] CSP is on the rise, and the treatment should be taken according to the individual principle. The methods of MTX ＋ mifepristone ＋ curettage and UAE＋ curettage are safe and effective in treating CSP, and lesion resection can shorten the treatment cycle.