子宫动脉化疗栓塞结合清宫术治疗宫颈妊娠的疗效研究  

Cervical pregnancy treated by uterine artery chemoembolization combined with dilatation and curettage

作　　者：张伟[1] 侯保萍[2] 汤超[1] 李灵君[1] 徐红丽[2] 王慧霞[2] 

机构地区：[1]郑州市第一人民医院介入科,河南郑州450004 [2]郑州市第一人民医院妇科,河南郑州450004

出　　处：《实用放射学杂志》2015年第6期1006-1008,共3页Journal of Practical Radiology

摘　　要：目的：研究子宫动脉化疗栓塞结合清宫术在宫颈妊娠（CP）的疗效及安全性。方法对7例宫颈妊娠行子宫动脉化疗栓塞,经双侧子宫动脉灌注甲氨蝶呤,然后以明胶海绵颗粒栓塞子宫动脉,介入术后1周内行清宫术。结果子宫动脉化疗栓塞术后阴道出血均得到有效控制,6例患者1周内接受了清宫术,出血量10~30 mL,平均21 mL；β-HCG 在介入术后1周内降至正常范围者1例,其余6例3周内降至正常,平均（16.4±6.9）d；无严重并发症发生,随访未出现卵巢早衰症状。结论子宫动脉化疗栓塞结合清宫术显著提高 CP 疗效和安全性,避免了子宫大出血、子宫切除等严重并发症,临床应用安全、有效。Objective To evaluate the efficacy and safety of uterine artery chemoembolization（UACE）in conjunction with dilata-tion and curettage in the treatment of cervical pregnancy.Methods UACE was performed in 7 patients with cervical pregnancy,after bilateral uterine artery perfusion of methotrexate,using gelatin sponge for embolization.Dilatation and curettage was carried out within 1 week after the procedure.Results The symptom of vaginal bleeding was effectively controlled after UACE,then dilatation and curettage performed in 6 within 1 week,the blood loss during curettage procedure was 10-30 mL（mean 21 mL）.The serumβ-HCG decreased to normal range within 1 week in 1 and 3 weeks in 6 after intervention,average 1 6.4 ± 6.9 days.No serious com-plications occurred and follow up did not show symptoms of premature ovarian failure.Conclusion UACE combined with dilatation and curettage significantly improve the efficacy and safety of the treatment of cervical pregnancy,and avoid serious incident,such as massive hemorrhage and unnecessary resection,the clinical application is safe and effective.

关 键 词：宫颈妊娠 子宫动脉 栓塞 化学治疗 清宫术 

分 类 号：R714.22[医药卫生—妇产科学] R815[医药卫生—临床医学]