Clinical Analysis Of Different Treatments For Cesarean Scar Pregnancy

Objective: To investigate the clinical characteristics of cesarean scar pregnancy(CSP)and the clinical effect of different treatmens.Methods: The clinical data of 156 patients with CSP in Tianjin First Central Hospital from July 2015 to July 2018 were collected.According to the different treatments,they were divided into four groups:A group: drug treatment group;B group: operation group;C group: uterine curettage group;D group: uterine artery embolization+uterine curettage group.SPSS21.0 software was used for data collation and statistical analysis.The mean and standard deviation of measurement data are calculated if they are approximate to normal distribution,and expressed as ? x±s.If they are skewed distribution,the median is taken.Counting data are expressed in proportion(%).Kruskal-Wallis test was used to compare the measurement data.Results: 1.In group A,1 of the 4 patients was typeⅠCSP,who was treated successfully and 3 of the 4 patients were typeⅡCSP,who had poor therapeutic effect.2.Among the 5 patients in group B,3 patients were typeⅡCSP and 2 patients were type ⅢCSP.All of them were treated successfully.3.Among the 7 patients in group C,5 patients were typeⅠCSP and 2 patients were typeⅡCSP.All of them were treated successfully.4.Among 140 patients in group D,32 patients were typeⅠCSP,100 patients were type ⅡCSP,and 8 patients were type ⅢCSP.Among them,5 patients with typeⅡCSP had poor therapeutic effect and 11 patients had postoperative complications.The analysis data shows that : 1.Compared with group A,group C and group D,the decrease ratio of blood HCG was higher in group B(P<0.001;P=0.003;P=0.027);Compared with group A,the decrease ratio of blood HCG was higher in group D(P=0.039);there was no statistical difference between group A and group C,group C and group D(P>0.05).2.The hospitalization time of group A was longer than that of group C and group D(P=0.001;P=0.005);the hospitalization time of group B was longer than that of group C(P=0.009);there was no statistical difference between group A and group B,group B and group D,group C and group D(P>0.05).3.The hospitalization expenses of group C were lower than those of group B and group D(P<0.001);the hospitalization expenses of group D were lower than those ofgroup B(P=0.012);there was no statistical difference between group A and group B,group C and group D(P>0.05).Conclusion: 1.At present,there are many treatments available for cesarean scar pregnancy.The clinical treatment should be individualized according to patients’ age,clinical manifestations,imaging characteristics,fertility requirements and patients’ wishes.2.Uterine artery embolization + uterine curettage is an effective,safe and economical treatment.