急诊子宫动脉栓塞术治疗子宫切口妊娠大出血  

Uterine Artery Embolization in Treating Emergency Cesarean Scar Pregnancy Massive Bleeding

作　　者：曹跃勇[1] 朱军[1] 黄勇[1] 杜旭洋 张川利[2] 浦丹[2] 

机构地区：[1]宜宾市第二人民医院影像科,四川宜宾644000 [2]宜宾市第二人民医院妇科,四川宜宾644000

出　　处：《华西医学》2012年第11期1664-1666,共3页West China Medical Journal

摘　　要：目的探讨急诊行子宫动脉灌注药物栓塞术治疗剖宫产后切口妊娠的可行性和临床价值。方法 2009年10月-2011年12月,对17例临床证实切口瘢痕妊娠并阴道出血患者,急诊行双侧子宫动脉灌注甲氨蝶呤并超选择栓塞术,术后通过观察人绒毛膜促性腺激素(HCG)水平、阴道出血及术后清宫术来评价疗效。结果 17例患者急诊行子宫动脉灌注栓塞术成功,术后阴道出血均停止或减少,HCG水平均明显下降,3例因孕囊自行排除而未行清宫,14例术后2～4 d行胚胎钳刮术,术中出血量较少。所有患者1周后均治愈出院。结论子宫动脉灌注栓塞术是治疗剖宫产术后切口瘢痕妊娠的一种有效方法,可及时治疗阴道大出血,促进杀胚,并为术后清宫提供安全保障。Objective To investigate the feasibility and value of uterine artery embolization by drug perfusion in treating cesarean scar pregnancy（CSP） after cesarean section.Methods Between October 2009 and December 2011,17 patients diagnosed to be with CSP and colporrhagia underwent bilateral uterine artery superselective embolization with perfusion of methotrexate.After the surgery,we observed HCG level and vaginal bleeding to evaluate the therapeutic effect. Results All the 17 patients underwent the surgery successfully with no or lessened vaginal bleeding,and lower HCG level.Three patients did not undergo complete curettage of the uterine cavity owing to the self-discharge of gestational sac.Fourteen patients underwent embryonic curettage within 2 to 4 days after surgery with little intraoperative bleeding. All patients were cured and discharged one week after surgery.Conclusion Uterine artery embolization is an effective treatment for cesarean scar pregnancy,which can stop vaginal massive bleeding timely,promote embryo killing,and provide security for the later curettage.

关 键 词：切口妊娠 子宫动脉 栓塞 大出血 

分 类 号：R714.22[医药卫生—妇产科学]