中文摘要：

目的 探讨外生型剖宫产术后子宫瘢痕妊娠（CSP）应用子宫动脉栓塞术（UAE）联合宫腔镜手术治疗的临床价值及安全性.方法 收集2015年1月至2016年1月在菏泽市妇幼保健院手术治疗的84例外生型剖宫产术后CSP患者临床资料,随机分为观察组和对照组两组,每组42例.两组患者均接受宫腔镜手术,对照组采用肌注甲氨蝶呤治疗,观察组采用双侧子宫动脉栓塞术治疗;对比两组患者的手术时间、术中出血量、术后肛门首次排气时间、术后血人绒毛膜促性腺激素（HCG）转阴时间、总住院时间、病灶消失时间、月经恢复时间以及不良反应发生率.结果 对照组患者手术时间、术后肛门首次排气时间及住院时间均较观察组长,且术中出血量也较观察组多,差异有统计学意义（P〈0.05）.观察组患者术后血HCG转阴时间、病灶消失时间、月经恢复时间均较对照组要短,差异有统计学意义（P〈0.05）.不良反应以出血、腹痛、发热、臀部疼痛为主,对照组不良反应发生率为9.52%（4/42）,观察组不良反应发生率为7.14%（3/42）,差异无统计学意义（P〉0.05）.结论 外生型剖宫产术后CSP的患者,宫腔镜手术同时联合子宫动脉栓塞术能够有效提高手术效率,减轻患者的损伤,帮助患者术后尽早恢复病情,同时不良反应率低,手术安全可靠,值得临床推广.

英文摘要：

Objective To investigate the clinical value and safety of uterine artery embolization combined with hysteroscopy in the treatment of uterine scar pregnancy after cesarean section. Methods A total of 84 patients uterine scar pregnancy were selected after cesarean section cases with surgical treatment from January 2015 to January 2016 in Heze city of Shandong province maternal and child health care. Ac-cording to the random principle, the cases were divided into two groups, all patients underwent hystero-scopic surgery, control group received intramuscular injection of methotrexate, and observation group un-derwent bilateral uterine artery embolization, compared between the two groups in operative time, bleeding volume, postoperative first anal exhaust time, postoperative blood HCG clearance time, total length of time, the lesion disappeared, menstrual recovery time and adverse reaction incidence rate. Results Con-trol group of operative time, postoperative first anal exhaust time and total hospital stay were longer than ob-servation group, and bleeding volume also was more than in the observation group, the differences were sta-tistically significant（P〈0. 05）. The observation group of patients with postoperative blood HCG negative time, lesions disappeared, menstrual recovery time were shorter than control group, the difference was sta-tistically significant（P〈0. 05）. The main adverse reactions were bleeding, abdominal pain, fever and hip pain, the control group was 9. 52%（4/42）, the observation group was 7. 14%（3/42）, the difference was not statistically significant （P〉0. 05）. Conclusion For patients with uterine scar pregnancy after cesare-an section, undergoing hysteroscopy surgery also combined with uterine artery embolization can effectively improve the operation efficiency, reduce injury to patients, help patients recovery from the illness, and adverse reaction rate is low, the operation is safe and reliable, it is worth clinical promotion.