用氨甲喋呤+平阳霉素碘油乳剂介入治疗高风险子宫疤痕妊娠  

Interventional therapy of high-risk cesarean scars pregnancy by using methotrexate and pingyangmycin lipiodol emulsionin

作　　者：汪永平 岳红萍 费利虎 刘灿 易炜 邱皓 张荣顺 母德睿 李升旺 夏体考 胡红文 

机构地区：[1]云南省第三人民医院放射科,云南昆明650011 [2]云南省第三人民医院妇科,云南昆明650011

出　　处：《医学影像学杂志》2016年第8期1491-1493,共3页Journal of Medical Imaging

摘　　要：目的探讨氨甲喋呤加平阳霉素碘油乳剂介入治疗高风险子宫切口疤痕妊娠(CSP)的疗效和安全性。方法选取临床确诊CSP且孕囊位于肌层向外生长、供血丰富、原始胚胎生长活性程度高的高风险者51例,使用氨甲喋呤+平阳霉素碘油乳剂行子宫动脉化疗栓塞术(UACE)治疗,术后观察患者副反应、并发症、临床效果。结果全部病例UACE治疗1次成功,并保留住子宫,术后副反应少、轻,无治疗相关并发症,临床跟踪观察4例和病理检查47例证实全部杀死胚胎,无大出血发生。结论使用氨甲喋呤+平阳霉素碘油乳剂行UACE治疗高风险CSP临床效果好、安全性高。Objective To explore the effect and safety of interventional treatment of high-risk cesarean scars pregnancy （CSP） by using methotrexate and pingyangmycin lipiodol emulsionin. Methods The clinical diagnosis of 51 patients with CSP were selected, whose pregnant bursa was located in the muscle layer, outward growth, rich blood supply and the original embryo growth in high activity. Uterine artery ehemoembolization （UACE） was bilateral uterine artery pourinto with MTX of 50mg/m2 （body surface area） and a small amount of pingyangmycin iodized oil emulsion, embolization with gelatin sponge particles. After the operation, the side effects and the complications and the clinical effect were observed. Results All cases of UACE were successful treatment once and retained the uterus, with less side effects. There was no treatment related complications. Following up the clinical course in 4 cases and pathological examination of 47 cases, all embryoes were killed, no large hemorrhage occurred. Conclusion UACE by using methotrexate and pingyangmycin lipiodol emulsionin has good effect, high safety in interventional treatment of high-risk CSP.

关 键 词：子宫疤痕妊娠 高风险 氨甲喋呤 平阳霉素碘油乳剂 介入治疗 

分 类 号：R714.2[医药卫生—妇产科学] R815[医药卫生—临床医学]