甲氨蝶呤子宫动脉栓塞联合B超引导下清宫治疗瘢痕妊娠43例分析  

Methotrexate used in uterine artery embolization combined with B-ultrasound guided curettage for treatment of Cesarean scar pregnancy：a 43-case study

作　　者：张丽卿[1] 刘芳[1] 戚潜辉[1] 

机构地区：[1]广州医科大学附属第二医院妇科,510260

出　　处：《中华生物医学工程杂志》2017年第2期166-168,共3页Chinese Journal of Biomedical Engineering

摘　　要：目的 探讨瘢痕妊娠（CSP）的治疗方法.方法 应用甲氨蝶呤（MTX）子宫动脉栓塞联合B超引导下清宫治疗CSP病例共43例次,按CSP临床分型,Ⅰ型14例,Ⅱ型23例,Ⅲ型6例.结果 43例次CSP治愈率97.7%,全部无需切除子宫,除1例重复CSP患者术中出血300 ml外,其余42例次术中出血5~80 ml（20±5）ml,总住院天数为3~14（5.6±2.3）d,β-HCG下降至正常为21~40 d,月经恢复时间为30~55 d.结论 应用MTX子宫动脉栓塞联合B超引导下清宫治疗瘢痕妊娠安全可靠、疗效确定,创伤小,适合各型CSP患者.Objective To explore the treatment strategy for cesarean scar pregnancy （CSP）. Methods A total of 43 procedures,including 14 cases of type Ⅰ,23 of type Ⅱ and 6 of type Ⅲ CSP by clinical classification,were performed through methotrexate （MTX） uterine artery embolization combined with B-ultrasound guided curettage. Results The curative rate was 97.7% in the 43 cases,with none necessitating hysterectomy. The blood loss during procedures was 5 to 80（20±5）ml in 42 cases,except for 300 ml in one case of repeated CSP. The total days of hospital stay was 3 to 14（5.6±2.3）d.β-HCG decreased to normal in 21 to 40 d. Menstrual periods recovered in 30 to 55 days. Conclusion MTX uterine artery embolization combined with B-ultrasound guided curettage for treatment of CSP is safe and reliable with definite curative efficacy and minimal invasiveness,and is recommendable for all types of CSP patients.

关 键 词：甲氨蝶呤 瘢痕 超声检查 介入性 子宫动脉栓塞 

分 类 号：R714.22[医药卫生—妇产科学]