子宫动脉栓塞联合刮宫术治疗瘢痕妊娠疗效及其远期影响  

Effect of uterine artery chemoembolization combined with dilatation and curettage for scar pregnancy and its long-term impact on patients

作　　者：刘瑞青[1] 曹会存[1] 曹广劭[1] 李辉[1] 刘健[1] 刘玉岩[1] 李陆鹏[1] 刘建文[1] LIU Ruiqing;CAO Huicun;CAO Guangshao;LI Hui;LIU Jian;LIU Yuyan;LI Lupeng;LIU Jianwen(Department of Interventional Therapy,Henan Provincial People's Hospital, Zhengzhou 450003,China)

机构地区：[1]河南省人民医院综合介入科,河南郑州450003

出　　处：《中国介入影像与治疗学》2018年第10期597-600,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨子宫动脉化疗栓塞(UACE)联合刮宫术治疗瘢痕妊娠(CSP)的疗效及其远期影响。方法连续收集接受UACE联合刮宫术治疗的101例CSP患者,评价UACE预防刮宫时大出血等严重后果的作用,术后随访月经复潮时间、月经周期是否规律、行经时间及月经量情况,采用SPSS 17.0软件分析各因素对患者术后月经量的影响。结果 101例中,仅2例发生刮宫时大出血;UACE临床成功率98.02%(99/101)。术后中位随访时间37.5个月(16.5～65.5个月),中位月经复潮时间1.5个月(0.5～3.0个月),月经周期规律,中位行经时间3天(1～5天)。60例术后月经量减少(包括1例闭经),41例术后月经量正常。术后月经量减少与月经量正常患者间年龄、术前β-人绒毛膜促性腺激素(β-HCG)水平、流产次数、剖宫产次数、刮宫术距UACE的间隔时间、刮宫术中清出组织重量及术中出血量差异均无统计学意义(P均>0.05),UACE栓塞材料差异亦无统计学意义(χ2=1.10,P=0.58)。结论 UACE联合刮宫术治疗CSP安全、有效,但存在术后月经量减少及闭经风险。Objective To investigate the effect of uterine artery chemoembolization(UACE)combined with dilatation and curettage for scar pregnancy(CSP)and its long-term impact on the patients.Methods Totally 101 CSP patients were enrolled and treated with UACE combined with dilatation and curettage.The effect of UACE on prevention of severe bleeding during curettage was evaluated.Postoperative follow-up was performed to collect clinical information,including the time of menstruation recovery,menstruation regular or not,menstrual period and menstrual volume.The impact of clinical factors on the changes of postoperative menstrual volume was analyzed with SPSS 17.0 software.Results Severe bleeding during curettage occurred in 2 patients.The clinical success rate of UACE was 98.02%(99/101).The median follow-up time was 37.5 months(16.5-65.5 months).The menstruation was regular,the median time of menstruation recovery and menstrual period was 1.5 months(0.5-3.0 months)and 3 days(1-5 days),respectively.There were 60 patients with decreasing menstrual volume(including 1 case of amenorrhea)and 41 patients with normal menstrual volume after treatment.The differences of patients'age,preoperative level ofβ-human chorionic gonadotropin(β-HCG),abortion times,cesarean delivery times,interval of cesarean and UACE,weigh of curettage tissue and blood loss during curettage were not statistically significant between patients with decreasing and normal menstrual volume after treatment(all P>0.05).Meanwhile,there was no statistical difference of embolization material of UACE between patients with decreasing and normal menstrual volume after treatment(χ2=1.10,P=0.58).Conclusion UACE combined with dilatation and curettage for CSP is safe and effective.However,some patients may have decreased menstrual flow even amenorrhea after treatment.

关 键 词：妊娠 异位 子宫动脉 栓塞 治疗性 刮宫术 

分 类 号：R714.22[医药卫生—妇产科学] R815[医药卫生—临床医学]