子宫动脉化疗栓塞术治疗剖宫产子宫瘢痕妊娠的疗效  

Efficacy of uterine artery chemoembolization in treatment of cesarean scar pregnancy

作　　者：张伟[1] 侯保萍[2] 徐红丽[2] 李灵君[1] ZHANG Wei HOU Baoping XU Hongli LI Lingjun(Department of Interventional Radiology Department of Gynaecology , the First People＇s Hospital of Zhengzhou, Zhengzhou 450004, China)

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：《中国介入影像与治疗学》2017年第1期13-17,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨子宫动脉化疗栓塞术(UACE)治疗剖宫产子宫瘢痕妊娠(CSP)的疗效及安全性。方法对26例CSP患者UACE后行清宫术,观察并记录UACE和清宫术的并发症、血清β-HCG和月经恢复正常的时间,对UACE前和术后1天、4天、1周血清β-HCG进行对比;根据UACE前血清β-HCG水平将患者分为A组(血清β-HCG≥10 000mIU/ml)和B组(血清β-HCG<10 000mIU/ml),对比组间孕周、前次剖宫产距今时间、清宫术中出血量的差异。结果 UACE技术成功率为100%;术后阴道出血均得到有效控制,清宫术中出血量5~400 ml,无严重并发症发生;UACE前和术后1天、4天、1周血清β-HCG差异有统计学意义,UACE术后血清β-HCG较术前显著下降;两组年龄、孕周、前次剖宫产距今时间、清宫术中出血量差异均无统计学意义(P均>0.05),两组既往孕次、血清β-HCG降至正常的时间差异均有统计学意义(P均<0.05)。结论 UACE在CSP的治疗中有较好的疗效及安全性,无论血清β-HCG水平高低,均可达到保留子宫和生育能力目的。Objective To study the efficacy and safety of uterine artery chemoembolization （UACE） in treating cesarean scar pregnancy （CSP）. Methods UACE were performed in all 26 cases of CSP before curettage. The data of complications of UACE and curettage, the serum β-HCG and menstrual recovery time, the serum β-HCG of preoperative and 1 day, 4 days and 1 week postoperative were recorded and compared. The preoperative serum β-HCG≥10 000 mIU/ml were divided into group A, and 〈10 000 mIU/ml was group B; the difference of gestational weeks, the time of the last caesarean section, the amount of bleeding during curettage were compared. Results The success rate of UACE was 100%, and vaginal bleeding was effectively controlled. The amount of bleeding during curettage was 5-400 ml, no serious complications occurred and all 26 patients were cured. The serum β-HCG of preoperative and 1 day, 4 days and 1 week postoperative had statistically significant, which of the postoperative was significantly lower than those before UACE. There was no statistical difference between the two groups in ages, gestational weeks, the time of the last caesarean section and the amount of bleeding during curettage, and statistical differences were found in the number of pregnancy and the time of serum β-HCG decreased to normal range. Conclusion UACE shows excellent effect and safety in treating CSP, regardless of the level of serum β-HCG, the purposes of preserving the uterus and fertility are both achieved.

关 键 词：化疗栓塞 清宫术 血管造影术 数字减影 妊娠 异位 

分 类 号：R714.22[医药卫生—妇产科学]