不同类型子宫瘢痕妊娠动脉栓塞治疗前后病灶血流变化的研究  

Study on hemodynamic changes of pregnancy tissue material before and after the artery embolization in different types of cesarean scar pregnancy

作　　者：陈莉婷[1] 陈向东[1] 汪洪[1] 

机构地区：[1]广东省佛山市妇幼保健院妇科,广东佛山528000

出　　处：《中国医药科学》2016年第14期101-104,共4页China Medicine And Pharmacy

摘　　要：目的通过对各种类型的子宫瘢痕妊娠（CSP）进行子宫动脉栓塞治疗,观察动脉栓塞治疗前后病灶局部的血流动力学变化,探讨动脉栓塞治疗对各种类型子宫瘢痕妊娠的疗效。方法选择佛山市妇幼保健院2007年1月~2015年12月收治的CSP患者共124例,应用B超影像学将CSP患者分为Ⅰ型、Ⅱ型及ⅡⅢ型,分别对应为A（38例）、B（46例）、C（40例）三组,全部行双侧子宫动脉栓塞治疗,72h后行清宫术,比较三组患者介入治疗的有效率、介入治疗后血液β-HCG下降情况及妊娠组织物局部的血流阻力指数变化。结果 （1）三组患者有效率分别为95.00%、95.83%及100.00%,无统计学差异（P〉0.05）。总有效率达96.88%。（2）三组患者血流阻力指数下降50%所需时间分别为A组（42.65±13.17）h,B组（56.31±16.25）h,C组（29.72±9.26）h,三组患者时间差别之间的比较差异均有统计学意义（P〈0.05）。（3）三组患者血液β-HCG下降50%所需时间分别为A组（5.37±1.52）d,B组（5.84±1.21）d,C组（3.52±1.02）d,其中A、B两组差异无统计学意义（P〉0.05）,A、C与B、C两组之间差异有统计学意义（P〈0.05）。结论动脉栓塞治疗对各种类型的CSP均有较好的疗效,但对于治疗的个体化实施方案的确定,仍需要进一步研究。Objective By performing uterine artery embolization in treating cesarean scar pregnancy, to observe hemodynamic changes of pregnancy tissue material before and after uterine artery embolization in different types of uterine scar pregnancy, and to explore the effects of uterine artery embolization in treating cesarean scar pregnancy. Methods 124 patients with cesarean scar pregnancy were divided into type Ⅰ, type Ⅱ and type Ⅲ by B ultrasound imaging, which were selected from January 2007 to December 2015 in the Maternal and Child Health Hospital of Foshan City in this study. Patients in Type Ⅰ, type Ⅱ and type Ⅲ were corresponding to group A（38 cases）, B（46 cases）, C（40 cases）, respectively. All patients underwent curettage treatment at 72 h after bilateral uterine artery embolization. The clinical results of the three groups were compared, including efficiency of therapy, decreasing of blood β-HCG and flow resistance index in pregnancy tissue material. Results（1）The effective rate of the group A, B, C were 95.00%, 95.83% and 100.00% individually, there were no significant differences among the three groups（P〉0.05）. The total effective rate was 96.88%.（2）The mean time of flow resistance index decreased by 50% were（42.65±13.17） h in group A,（56.31±16.25） h in group B, and（29.72±9.26） h in group C. There were statistically significant differences（P〈0.05） among each group.（3） The mean time of blood β-HCG decreased by 50% were（5.37±1.52） d in group A,（5.84±1.21） d in group B and（3.52±1.02） d in group C. There was no significant difference（P〈0.05） between group A and group B. There were significant differences between group A and group C and between group B and group C（P〈0.05）. Conclusion Uterine artery embolization has good effect in all kinds of cesarean scar pregnancy. However, further research is needed to determine the individual implementation plan for the treatment.

关 键 词：子宫动脉栓塞 子宫瘢痕妊娠 超声诊断 治疗 

分 类 号：R719.8[医药卫生—妇产科学]