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目的:探讨剖宫产瘢痕妊娠(CSP)的个体化综合治疗方法。方法:2006年12月～2012年12月,根据剖宫产史、妊娠表现、经阴道超声诊断,确诊CSP患者38例。按血β-人绒毛促性腺激素(β-HCG)水平、妊娠囊与子宫切口的关系及局部血运情况,26例首选甲氨蝶呤(MTX)化疗,10例首选清宫术,2例首选手术治疗,结果:26例经MTX化疗后,15例患者仅保守治疗未行清宫术,11例待血HCG下降80%～90%、病灶血流减少或消失后行病灶清除术;10例患者首选清宫术,均痊愈出院。结论:CSP的治疗应依据血β-HCG水平和病灶部位、表面肌层厚度、血供及阴道流血情况,选择个体化综合治疗方式。
Objective: To investigate the individualized comprehensive treatment of cesarean scar pregnancy (CSP). Methods: From December 2006 to December 2012, 38 patients with CSP were diagnosed according to the history of cesarean section, pregnancy performance and transvaginal ultrasound. According to the level ofβ-human chorionic gonadotropin (β-HCG), the relationship between gestational sac and uterine incision and local blood supply, 26 patients were selected methotrexate (MTX) chemotherapy, 10 patients were selected for radical mastectomy and 2 patients preferred Surgical treatment, the results: 26 patients after MTX chemotherapy, 15 patients with conservative treatment only did not curettage, 11 cases of HCG decreased by 80% to 90%, lesion blood flow reduction or disappearance of lesions removed; 10 patients The preferred curettage, were cured and discharged. Conclusion: The treatment of CSP should be based on the level of blood β-HCG and lesion site, surface myometrial thickness, blood supply and vaginal bleeding, choose individualized comprehensive treatment.