甲氨蝶呤、米非司酮联合清宫术治疗剖宫产后子宫瘢痕部位妊娠

Clinical study on 45 cases with endogenous caesarean scar pregnancy

目的：探讨甲氨蝶呤＋米非司酮超声引导下清宫术治疗内生型剖宫产后子宫瘢痕部位妊娠（CSP）的应用价值。方法分析43例采用甲氨蝶呤＋米非司酮治疗后超声引导下清宫术治疗内生型剖宫产后子宫瘢痕部位妊娠患者的临床资料。结果39例成功，4例改开腹病灶切除术，7例清宫术后出血宫腔内放置 Foley 双腔导尿管压迫止血成功。结论甲氨蝶呤＋米非司酮治疗后超声引导下清宫术治疗内生型剖宫产后子宫瘢痕部位妊娠是一种创伤小、安全、有效、治疗费用低的方法，尤其适用于基层医院应用。

Objective To study the effect of ultrasound guided curettage after methotrexate and mifepristone in the treatment of endogenous caesarean scar pregnancy.Methods A retrospective analysis was performed on 43 patients of endogenous caesarean scar pregnancy undergoing treatment of ultrasound guided curettage after methotrexate and mifepristone.Results 39 cases were successful,4 cases were transformed to laparotomy because of intraoperative blood loss,7 cases of bleeding after curettage were successful by uterine carity placed double lumina Foley catheter. Conclusion Ultrasound guided curettage after methotrexate and mifepristone is a safe,effective,little trauma and low cost method in the treatment of endogenous caesarean scar pregnancy,it especially adapts to primary hospital.