探讨疤痕妊娠(CSP，cesarean scar pregnancy)的治疗方法。方法 回顾性分析我院2010年1月至2013年6月收治40例剖宫产疤痕妊娠的诊治过程。结果 其中30例初诊即确诊疤痕妊娠，10例误诊为早孕患者经后期治疗确诊疤痕妊娠。30例初诊确诊病例中，17例确诊疤痕妊娠后直接行介入治疗+氨甲喋呤，13例行药物保守治疗+清宫术。比较该30名患者的治疗结果发现介入治疗在手术时间，术中出血量方面较药物治疗均有明显优势p<0.05。结论 剖宫产疤痕妊娠治疗方法较多，有保守治疗、介入治疗和手术治疗，早诊断、早治疗，可获得满意疗效。我科目前运用介入结合清宫治疗，疗效确切，较其他治疗方法具有出血量少，创伤小及住院时间短等优势。
Objective To provided evidence for guided uterine artery embolization as a secured therapy for cesarean scar pregnancy (CSP).Methods We retrospectively studied 40 CSP patients’ therapeutic methods and outcomes from January 2010 to June 2013.Results Of these 40 patients, 30 were diagnosed CSP immediately, 10 were miss-diagnosed as normal pregnancy and turned out CSP later-on.Of those 30 patients, 17 received uterine artery embolization with methotrexate plus D&C; 13 received conservative medical therapy plus D&C.When compared these 30 patients therapeutic outcomes, guided uterine artery embolization has shown an apparent advance in operation duration, blood loss (p<0.05).Conclusion There were multiple therapies for CSP including conservative therapy, embolization therapy, operation therapy, and early diagnose, early therapy could get a satisfactory effect.Our therapy:uterine artery embolization with methotrexate plus D&C is a therapy which had merits of less blood loss, mini-invasive and shorter inpatient duration.
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