宫腔镜手术联合甲氨蝶呤治疗剖宫产术后子宫瘢痕妊娠的临床疗效分析

目的 探讨宫腔镜联合甲氨蝶呤治疗剖宫产术后子宫瘢痕妊娠的应用价值。方法 46例CSP患者在B超引导下向妊娠囊内注射甲氨蝶呤,当CSP患者血清β-HCG值下降至200 mmol/L以下,B超显示妊娠包块缩小,且孕囊周围无血流时,联合宫腔镜电切术,清除妊娠组织。结果 所有患者手术均一次性成功。手术时间平均约30 min,血量约在50～180 ml,术后患者血清β-hCG值均明显下降,直到恢复正常。所有患者均治愈出院,平均住院3周,术后1个月恢复月经。结论 宫腔镜联合甲氨蝶呤治疗CSP临床效果好,且安全可靠,值得临床推广。

Clinical effect analysis of hysteroscopy surgery combined with methotrexate to treat cesarean scar pregnancies

Objective To evaluate the applicative value of hysteroscopy operation combined with methotrexate to treat cesarean scar pregnancies. Methods 46 cases of cesarean scar pregnancy （ CSP ） patients were injected with methotrexate into gestational sac by B ultrasound - guided. When the level of β - HCG in serum gradually has dropped to below 200 mmol/L and B ultrasound has showed a shrinking gestational mass and no blood around gestational sac, hysteroscopy were combined to remove gestational tissues. Results All patients＇operation had succeeded by one time. The mean operation time was about 30 min,and blood flow were approximately in the range of 50 - 180 mL. Serum β - hCG values were significantly decreased and returned to normal after surgery. All patients were cured and restore menstruation in one month after surgery. The average hospitalization time was three weeks. Conclusion Hysteroscopy surgery combined with methotrexate to treat CSP patients is the most effective measure and worth to be popularization and application.