米非司酮联合吸宫术治疗剖宫产瘢痕部位妊娠的价值

Application value of mifepristone and uterine aspiration in treatment of caesarean scar pregnancy

目的探讨米非司酮联合吸宫术在剖宫产瘢痕部位妊娠(CSP)的治疗价值。方法回顾性分析24例CSP患者的临床表现和治疗结局。结果 24例患者均进行口服米非司酮片联合吸宫术,23例成功。1例施行子宫动脉栓塞术后,成功止血;孕囊在4.1cm×1.6cm以下患者出血量显著少于孕囊在4.1cm×1.6cm以上的患者,差异具有统计学意义(P<0.05);停经天数60d以内患者出血量显著少于停经天数超过60d的患者,差异具有统计学意义(P<0.05)。结论对于妊囊小、孕期短、血HCG值较低的患者可采用米非司酮联合吸宫术及时终止妊娠,可达到良好的治疗效果,为一种经济、简单,效果较好的治疗方式,但是考虑到大出血的可能,术前应做好应急实施子宫动脉栓塞术的准备。

Objective： To study the application value of mifepristone and uterine aspiration in treatment of caesarean scar pregnancy. Methods. The data including clinical manifestation, diagnosis and treatment and outcome of 24 patients with caesarean scar pregnancy were retrospectively analyzed. Results： All 24 patients were treated with mifepristone and uterine aspiration. Twenty three patients were cured, and one patient stopped bleeding by treated with uterine artery embolization. The bleeding amount was significant less in patients with gestational sac less than 4.1 cm×1.6 cm than that of more than 4.1 cm× 1.6 cm（P〈0.05）. The bleeding amount of patients within 60 days of pregnancy was significant less that of over 60 days（P〈0.05）. Conclusions： Treatment with mifepristone and uterine aspiration can successfully terminate pregnancy in the patients with caesarean scar, small gestational sac, short-term pregnancy and low HCG levels. It is economical, simple and good treatment method. Considering the possibility of hemorrhage, it is necessary to prepare uterine artery embolization before the uterine aspiration.