【摘要】 目的 分析不同手术方式治疗剖宫产Ⅱ型瘢痕妊娠对再次妊娠的影响。方法 选取2015年8月- 2022年3月收治的剖宫产Ⅱ型瘢痕妊娠(CSP)患者284例为研究对象；选择其中行清宫术(彩超监测下或联合宫腔镜)的147例患者为A组；选择行子宫动脉介入栓塞后再行清宫术的73例患者为B组；选择行腹腔镜下子宫瘢痕妊娠物清除+修补术的64例患者为C组。所有患者随访时间2年，比较三组患者的再次妊娠率、再次CSP、异位妊娠、早产流产、足月产等情况。结果 共有174例患者自然妊娠，自然妊娠率为61%，三组患者再次妊娠率比较，差异无统计学意义(P>0.05)。三组患者术后异位妊娠、流产(自然流产和稽留流产)、足月产、再次CSP的发生率比较，差异均无统计学意义(P>0.05)。结论 三种手术方式治疗Ⅱ型子宫瘢痕妊娠均有良好的自然妊娠率，腹腔镜下子宫瘢痕妊娠物清除+修补术治疗Ⅱ型子宫瘢痕妊娠不能减少再次瘢痕妊娠的发生。

    【关键词】 Ⅱ型瘢痕妊娠；子宫动脉介入栓塞；腹腔镜下子宫瘢痕妊娠物清除+修补术；再次妊娠

    中图分类号 R714.2 文献标识码 A 文章编号 1671-0223(2024)19--03

    Impact of different surgical methods for treating type Ⅱ scar pregnancy on subsequent pregnancies Wu Boming， Lan Liubing. The First Clinical College of Guangdong Medical University， Meizhou 514000， China

    【Abstract】 Objective To analyze the impact of different surgical methods for treating type Ⅱ scar pregnancy in cesarean section on subsequent pregnancies. Methods 284 patients with type Ⅱ scar pregnancy (CSP) who underwent cesarean section from August 2015 to March 2022 were selected as the study subjects; 147 patients who underwent curettage surgery (under ultrasound monitoring or combined with hysteroscopy) were selected as Group A; 73 patients who underwent uterine artery embolization followed by uterine curettage were selected as Group B; 64 patients who underwent laparoscopic uterine scar removal and repair surgery were selected as Group C. All patients were followed up for 2 years to compare the rates of re pregnancy ......