高强度聚焦超声联合清宫术治疗带器再次剖宫产术后子宫瘢痕妊娠合并巨大子宫肌瘤一例

剖宫产术后子宫瘢痕妊娠（cesarean scar pregnancy，CSP）是一种特殊类型的异位妊娠，风险较大，诊治不及时可能造成严重不良后果，需尽早识别。近年高强度聚焦超声（high intensity focused ultrasound，HIFU）技术在妇产科领域广泛应用，该方法治疗CSP的报道也日渐增多，但尚未发现HIFU应用于带器CSP的治疗。回顾我院妇科2021年收治的1例HIFU联合清宫术成功治疗带器CSP病例，该患者为罕见的带器再次CSP，且合并巨大子宫肌瘤，临床处理较为棘手，若单纯行手术治疗将面临较高的临床并发症风险。本例通过HIFU联合清宫术治疗，不仅同时达到了对CSP和子宫肌瘤的治疗，还做到了创伤、费用和痛苦最小化。

A Case Report of Second Cesarean Scar Pregnancy with Intrauterine Device Complicated with Giant Hysteromyoma,Treated by HIFU Combined with Curettage

As a special type of ectopic pregnancies, cesarean scar pregnancy (CSP) has a high risk of severe adverse outcomes when untimely diagnosis and treatment occur. It is very necessary to identify it as soon as possible. In recent years, with the application of high intensity focused ultrasound (HIFU) in the field of obstetrics and gynecology, the reports of using HIFU to treat CSP are increasing. However, its application in treating the CSP with intrauterine device has not yet reported. We reported a case of second CSP with intrauterine device complicated with giant hysteromyoma. The patient was hospitalized in our hospital in 2021, who was cured by HIFU combined with curettage. In this case, the clinical treatment is more difficult, surgery alone will face a higher risk of clinical complications. However, HIFU combined with curettage not only achieved the effective treatment of CSP and hysteromyoma, but also minimized the trauma, cost and pain of patients.