子宫动脉化疗栓塞术联合清宫术治疗瘢痕妊娠疗效评价及影响因素分析  

Effect of combining uterine artery chemoembolization with curettage in treatment of caesarean scar pregnancy and influence factors

作　　者：余梁[1] 周丽芬[1] 含笑[1] 张刘 王国亮[1] 杜丹 胡茂能[1] YU Liang;ZHOU Lifen;HAN Xiao;ZHANG Liu;WANG Guoliang;DU Dan;HU Maoneng(Imaging Center,the Third People's Hospital of Hefei/Hefei Third Clinical College of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学合肥第三临床学院/合肥市第三人民医院影像中心,安徽合肥230000

出　　处：《实用放射学杂志》2019年第6期956-959,共4页Journal of Practical Radiology

基　　金：合肥市应用医学研究项目(hwk2017yb010)。

摘　　要：目的评价子宫动脉化疗栓塞术(UAC)联合清宫术治疗瘢痕妊娠(CSP)疗效并分析可能存在的影响因素.方法回顾性分析46例应用UAC联合清宫术治疗CSP患者的临床资料,对可能存在影响疗效的因素进行单因素分析,然后对有意义的变量构建Logistic回归模型。结果所有患者均成功中止妊娠。其中29例患者复查超声宫内无残留孕囊组织;17例患者宫内有部分残存孕囊组织,经应用中医药或甲氨蝶呤等对症治疗后中止妊娠。单因素分析显示,剖宫产次数、孕囊体积、孕周数、CSP类型、胎心搏动情况与治疗后宫内有无残留有关(P<0.05);多因素分析显示,孕囊体积>9cm^3、孕周数>7周及外生型CSP是宫内有无残留孕囊组织的独立影响因素。结论UAC联合清宫术治疗CSP疗效确切,临床应密切关注影响疗效的相关因素。Objective To evaluate the effect of combination of uterine artery chemoembolization and curettage in treatment of caesarean scar pregnancy(CSP),and to analyze the possible influence factors.Methods 46 cases with caesarean scar pregnancy treated by the combination of uterine artery chemoembolization and curettage were retrospectively analyzed.Univariate analysis was made on the factors that might influence the efficacy,and the Logistic regression model was constructed for the significant variables.Results All of the patients were terminated pregnancy succesfully .According to the ultrasound recheck,there were no residual gestational sac tissue in 29 patients,and some residual gestational sac tissue in 17 patients.After the application of traditional Chinese medicine or methotrexate and other symptomatic treatment, the pregnancy was terminated.The univariate analysis showed that the number of cesarean section,the gestational sac volume,the gestational weeks,the type of CSP,and the condition of the fetal heart pulsation were related to the presence of residues in the uterus after treatment (P<0.05).The multivariate analysis showed that gestational sac volume >9cm^3 ,gestational weeks > 7 weeks and exogenous CSP were the independent factors leading to intrauterine residual gestational sac tissue.Conclusion Uterine artery chemoembolization combined with curettage is an effective method for treatment of caesarean scar pregnancy.It is proposed that clinical treatment should pay close attention to the factors that may affect the efficacy.

关 键 词：化疗栓塞术 清宫术 子宫瘢痕妊娠 影响因素 

分 类 号：R815[医药卫生—放射医学] R713.41[医药卫生—临床医学]