子宫动脉栓塞联合清宫术治疗早期瘢痕妊娠(附21例报道)  

Uterine artery embolization before hysteroscope curettage in treating cesarean scar pregnany:Report of 21 cases

作　　者：姚志敏[1] 申太忠[1] 陈雯[2] 

机构地区：[1]中国医科大学附属航空总医院介入科,北京100012 [2]中国医科大学附属航空总医院妇产科,北京100012

出　　处：《中国介入影像与治疗学》2016年第6期334-337,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨对早期瘢痕妊娠（CSP）患者行双侧子宫动脉栓塞联合宫腔镜清宫治疗的可行性和安全性。方法回顾性分析2012年8月—2015年6月21例接受双侧子宫动脉化疗栓塞术后并于术后24~48h内接受宫腔镜清宫术的早期CSP患者资料。结果对21例患者双侧子宫动脉化疗栓塞术均操作成功,无严重并发症。栓塞术后清宫过程中出血量0~150ml。术前血HCG值为（41 866.71±26 374.59）U/L,术后3天血HCG值为（3 311.10±3 007.67）U/L。平均住院时间（6.95±1.86）天。术后平均随访时间（18.62±10.05）个月。术后2例月经量减少,1例月经量增多,1例表现为绝经前期改变,1例术后2年怀孕并正常分娩,余16例术后月经情况均无明显改变。结论对早期CSP患者行子宫动脉化疗栓塞联合宫腔镜清宫术安全、可行,可降低术后大出血风险并缩短住院时间。Objective To explore the feasibility and safety of uterine artery embolization before hysteroscope curettage in the treatment of cesarean scar pregnancy（CSP）.Methods From August 2012 to June 2015,uterine artery embolizations were performed on 21 patients with CSP.And then hysteroscope curettage was performed 24—48hours after embolizations.Results Uterine artery embolizations were completed successfully in all of 21 cases without critical complications.The bleeding volume during hysteroscope curettage was 0—150 ml.The serumβ-HCG level rapidly descended form（41866.71±26 374.59）U/L of pre-operation to（3 311.10±3 007.67）U/L of 3days after operation.The average hospital stay was（6.95±1.86）days.The average follow-up time was（18.62±10.05）month.The menstrual quantity decreased in 2cases and increased in 1case.One of them was in pre-menopause period.And 1case was pregnant on 2years after treatment with normal delivery.The other 16 cases had no obvious change in menstruation after treatment.Conclusion Uterine artery embolization before hysteroscope curettage in treating cesarean scar pregnancy is effective and safe.It can reduce the risk of critical bleeding and shorten the length of hospital stay.

关 键 词：瘢痕妊娠 子宫动脉 栓塞 治疗性 宫腔镜清宫术 

分 类 号：R714.22[医药卫生—妇产科学]