子宫动脉栓塞术治疗Ⅰ型剖宫产瘢痕部位妊娠的影响因素及疗效分析  

Factors analysis on uterine artery embolization in treatment of type Ⅰ caesarean scar pregnancy and its curative effect

作　　者：谢加琼 邓洁[1] 彭聪[1] 杨丹 邓晓杨[1] Jia-qiong Xie;Jie Deng;Cong Peng;Dan Yang;Xiao-yang Deng(Department of Gynaecology,The First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,China)

机构地区：[1]成都医学院第一附属医院妇科

出　　处：《中国现代医学杂志》2019年第24期90-93,共4页China Journal of Modern Medicine

摘　　要：目的分析子宫动脉栓塞术(UAE)应用于Ⅰ型剖宫产瘢痕部位妊娠(CSP)治疗中的影响因素及疗效。方法回顾性分析42例Ⅰ型CSP患者的临床资料,根据治疗方法将其分为介入组19例和非介入组23例。比较两组超声声像图特征、术前血人绒毛膜促性腺激素水平及手术相关并发症。结果两组瘢痕处肌层厚度、血流分型及孕囊与瘢痕关系比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,血流分型[OR=27.208(95%CI:1.744,424.451)]、孕囊与瘢痕关系[OR=11.120(95%CI=1.698,72.811)]是影响采用UAE治疗的独立因素。介入组均有不同程度的栓塞综合征发生,介入组远期月经量减少发生率高于非介入组(P<0.05)。结论UAE可较好地预防CSP清宫术过程中发生大出血。在Ⅰ型CSP中,可根据血流分型及孕囊与切口生长关系谨慎选择UAE,减少其并发症的发生。Objective To analyze the influencing factors and effects of uterine artery embolization(UAE)on the typeⅠcesarean scar pregnancy(CSP)treatment.Methods Clinical data of 42 cases with typeⅠcesarean scar pregnancy were retrospectively analyzed.According to different treatment methods,patients were divided into UAE group(19 cases)and control group(23 cases).The sonographic features,the level of hCG in blood before operation and the operation complications in the two groups between the two groups were compared.Results There were significant differences between thickness of residual muscle layer,blood supply and the location of pregnancy tissue(P<0.05).Logistic regression Analysis indicated that blood supply(OR=27.208,95%CI:1.744,424.451)and the location of pregnancy tissue(OR=11.120,95%CI:1.698,72.811)are independent factors in the treatment of typeⅠCSP.The UAE group all had different degree of embolism sydrome.The incidence of long-term menstrual volume reduction in the intervention group was higher than that in the non intervention group(P<0.05).Conclusion The CSP treated by the UAE can effectively prevent massive hemorrhage.In typeⅠCSP,UAE could be carefully chosen according to the blood supply and the location of pregnancy tissue to reduce complications.

关 键 词：子宫动脉栓塞术 剖宫产瘢痕部位妊娠 超声检查 多普勒 彩色 手术后并发症 

分 类 号：R619[医药卫生—外科学]