子宫动脉栓塞术治疗剖宫产后切口妊娠26例临床分析  

Uterine artery embolization for the treatment of cesarean scar pregnancy : clinical analysis of 26 cases

作　　者：欧阳栋 朱斌[2] 何晓音[2] 

机构地区：[1]新疆阿克苏第一人民医院妇科,新疆阿克苏830011 [2]浙江萧山医院妇科,浙江杭州311200

出　　处：《中国内镜杂志》2013年第6期631-635,共5页China Journal of Endoscopy

摘　　要：目的探讨子宫动脉栓塞术治疗剖宫产后切口妊娠(CSP)的疗效及价值。方法回顾性分析2006年5月～2010年12月浙江萧山医院收治的26例CSP患者,均行子宫动脉插管灌注甲氨蝶呤加双侧子宫动脉栓塞,然后行B超监护下清宫术。结果所有病例均治疗有效,阴道流血患者有效止血,血HCG下降明显,而后清宫术中无1例出现大出血。26例均送病理检查示:子宫瘢痕部位绒毛、蜕膜或胎盘组织,有变性、坏死。1例于介入治疗后发生卵巢早衰。结论子宫动脉栓塞术能有效控制切口妊娠大出血,有效杀死妊娠物,减少清宫出血量,针对清宫术中大出血、保守治疗后疗效欠佳、B超提示子宫肌层薄、孕囊及包块血流丰富、直径大于3cm等高危CSP,介入治疗有明显的效果。【Objective】To investigate the effect of uterine artery embolization to cesarean scar pregnancy （CSP）. 【Methods】The clinical data of 26 patients with CSP in our hospital from May 2006 to December 2010 were retrospectively analyzed .And all of them were applied with embolized by methotrexate perfusion and bilateral uterine artery embolization, then operated by uterine curettage monitored by B ultrasound. 【Results】All 26 patients received uterine artery embolization were effective, whose vaginal bleeding was hemostasised effectively, HCG in blood was decreased obviously, the uterine curettage had no hemorrhoea. All of the 26 cases were sent for histopathological examination, and showed： uterine scar villi, decidua and placenta, degeneration, necrosis. And one patient occurred premature ovarian failure after interventional therapy. 【Conclusion】Uterine artery embolization could control scar pregnancy bleeding effectively, killing pregnancy efficient, reduce the amount of bleeding. Interventional therapy is an effective method aimed at high risk CSP, such as uterine hemorrhage during currettage, poor outcome after conservation treatment, B ultrasound showed thin uterus muscle layer, rich flow of the gestational sac and mass, diameter greater than 3 cm.

关 键 词：剖宫产后切口妊娠 子宫动脉栓塞术 卵巢早衰 

分 类 号：R714.22[医药卫生—妇产科学]