子宫动脉灌注栓塞术在子宫瘢痕妊娠中的效果  

Application of uterine arterial infusion embolismin in the treatment of uterine scar pregnancy

作　　者：程青[1] 陈珂[2] 蔡满红[1] 张芬芬[1] 徐文健[1] 

机构地区：[1]南京医科大学附属南京市妇幼保健院妇产科,江苏南京210004 [2]南京医科大学附属南京明基医院妇产科,江苏南京210021

出　　处：《临床医学研究与实践》2016年第20期41-42,共2页Clinical Research and Practice

摘　　要：目的探讨子宫动脉灌注栓塞术用于子宫下段剖宫产术后瘢痕处妊娠的效果。方法回顾性分析我院收治的92例剖宫产术后子宫瘢痕处妊娠(CSP)患者的临床资料,根据治疗方法的不同分为甲组(24例)和乙组(68例)。甲组采用子宫动脉栓塞术+灌注甲氨喋呤进行治疗;乙组在甲组的治疗基础上联合刮宫术治疗。其中乙组44例患者在术后1周内进行刮宫术(乙1组),24例在术后1周后进行刮宫术(乙2组)。观察两组的疗效、出血量、血清人绒毛膜促性腺激素(β-HCG)下降情况及不良反应发生情况。结果两组患者均治疗成功,甲组患者血清人绒毛膜促性腺激素下降率低于乙组;乙1组阴道出血量少于乙2组(P<0.05)。结论子宫动脉灌注栓塞术治疗子宫下段剖宫产术后瘢痕处妊娠,安全有效。且子宫动脉灌注栓塞术后7 d内联合行刮宫术治疗效果更好。Objective To explore the efficacy of uterine arterial infusion embolismin （UAIE） in the treatment of cesarean scar pregnancy （CSP） after cesarean section in the lower part of the uterus. Methods The clinical data of 92 CSP patients in Affliated Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Hospital was retrospectively analyzed. According to the treatment programs, the patients were divided into group A （24 cases） and group B （68 cases）. The patients in group A received uterine arterial embolization （UAE） and methotrexate （MTX） infusion, and the patients in group B received uterine euretlage based on the treatment of group A. Forty-four cases of patients in group B received uterine curetlage within a week of the treatment （group B1）, and 24 cases received uterine curetlage a week after the treatment （group B2）. The efficacy, amount of bleeding, the decreasing of serum human chorionic gonadotropin （[3-HCG） and the occurrence of adverse reaction were observed and recorded. Results All the patients were cured. The serum human chorionic gonadotropin decline rate of patients in Group A was lower than that of group B; the amount of bleeding in group B1 was less than that of group B2 （P〈0.05）. Conclusion UAIE is a safe and effective therapeutic method of CSP treatment. Moreover, it is more effective to carry out the uterine curetlage within seven days after UAIE.

关 键 词：子宫动脉灌注栓塞术 子宫瘢痕处妊娠 刮宫术 

分 类 号：R714.2[医药卫生—妇产科学]