介入治疗83例剖宫产瘢痕部妊娠临床效果分析  

Observation on the Clinical Effect of Interventional Treatment for Cesarean Scar Pregnancy

作　　者：王蓓颖[1] 帅文[1] 王海云[1] 

机构地区：[1]同济大学附属第一妇婴保健院,上海200040

出　　处：《生殖与避孕》2013年第2期137-140,共4页Reproduction and Contraception

摘　　要：目的：评价介入治疗对剖宫产瘢痕部妊娠的临床效果。方法：回顾性分析83例因剖宫产子宫瘢痕部妊娠（CSP）行双侧子宫动脉化疗栓塞术介入治疗（UAE治疗）的临床效果。结果：①83例CSP患者术前B超诊断：早孕胚胎继续发育型52例；早孕胚胎停止发育型27例；流产出血型4例。经UAE后，79例在术后2448h行刮宫术，妊娠终止，术后1～2个月转经。3例继续妊娠，改用其他方法治疗：1例流产不全后子宫大出血，改行开腹手术。②术前胚胎继续发育型者52例，经UAE治疗后48h复查B超，胎心消失49例，胚胎灭活率为94．23％，3例仍然存活，占5．77％；胚胎早期停止发育型和流产出血型共31例全部妊娠终止。结论：UAE治疗是治疗CSP可靠、有效的方法，但对胚胎继续发育型的CSP有治疗失败的风险。Objective： To evaluate the clinical effect of intervention treatment for cesarean scar pregnancy （CSP）. Methods： A total of 83 CSP cases treated by uterine arterial embolization （UAE） were enrolled in this retrospective study. All women took the bilateral uterine artery embolization and chemotherapy. Results： 1） All cases were preoperatively diagnosed to three types according to the embryonic heartbeat by B-ultrasound, 52 cases were developing type, 27 cases were ceased type, and 4 cases were abortion hemorrhage type. Among 83 CSP patients after interventional therapy, 79 patients took curettage in the postoperative period of 24-48 h, then terminated pregnancy, whose menstruation was restored after 1-2 months, 3 cases who continued pregnancy and 1 case of massive hemorrhage after incomplete abortion were switched to the other treatment methods. 2） In 52 cases of developing type, reviewed by B-ultrasound in 48 h after interventional therapy, fetal heart disappeared in 49 cases （94.23%）, but 3 cases （5.77%） were still survived; 31 cases of cessation of development type and abortion hemorrhage type succeeded. Conclusion： Intervention treatment is the reliable and effective method for CSP, but for the type of continued developmental embryos still lies a risk of failure.

关 键 词：子宫动脉栓塞术(UAE) 剖宫产 子宫瘢痕部妊娠(CSP) 

分 类 号：R714.22[医药卫生—妇产科学]