子宫动脉栓塞术中附加栓塞侧支动脉的意义  

The additional embolization of collateral feeding the uterus in uterine artery embolization

作　　者：孙逢成 张克宁 李继军 唐军 孙增涛 张国栋 SUN Fengcheng;ZHANG Kening;LI Jijun;TANG Jun;SUN Zengtao;ZHANG Guodong(Department of Medical Imaging,Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan 271100,China;Department of Radiology,Shandong Pingdu TCM Hospital,Pingdu 266700,China;Department of Interventional Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]济南市中西医结合医院医学影像科,山东济南271100 [2]山东省平度市中医院放射科,山东平度266700 [3]山东第一医科大学附属省立医院医学影像介入治疗科,山东济南250021

出　　处：《医学影像学杂志》2022年第4期663-666,共4页Journal of Medical Imaging

摘　　要：目的探讨子宫动脉栓塞术(UAE)中附加栓塞侧支动脉的可行性、安全性和有效性。方法选取2012年1月~2019年8月瘢痕妊娠患者369例接受子宫动脉栓塞术联合宫腔镜清宫术,其中47例患者在子宫动脉栓塞术中进行了侧支供血动脉的尝试性栓塞。根据侧支动脉栓塞的成功与否将患者分成UAE+侧支动脉栓塞成功组和UAE+侧支动脉栓塞失败组,对两组患者进行了基础资料和临床疗效的对照。结果29例患者(61.7%)侧支动脉栓塞成功,其余18例(38.3%)侧支动脉栓塞失败。两组患者的年龄、孕龄、发病至上次剖宫产术的间隔时间、胎囊直径、基础血清人绒毛膜促性腺激素(β-hCG)水平、胎囊与膀胱间的肌层厚度、β-hCG恢复至正常的时间均无差异。UAE+侧支动脉栓塞成功组的清宫术中出血量明显少于UAE+侧支动脉栓塞失败组。结论在子宫动脉栓塞术联合宫腔镜清宫术治疗瘢痕妊娠中,侧支供血动脉栓塞在技术上是可行的,安全的,有助于减少清宫术中的出血量。Objective To evaluate the feasibility,safety and effectiveness of additional embolization of collateral feeding the uterus during uterine artery embolization(UAE).Methods From January 2012 to August 2019,among the 369 patients with cesarean scar pregnancy(CSP)receiving UAE followed by hysteroscopic curettage for the treatment of CSP,47 patients undergoing additional embolization of collateral feeding the uterus were included.Based on whether they underwent technically successful collateral embolization,the 47 patients were divided into UAE+successful collateral embolization group or UAE+failed collateral embolization group.The baseline characteristics and clinical outcomes were compared between the two groups.Results In the 47 patients included for evaluation,collateral embolization was successful in 29 patients(61.7%)and failed in the other 18 patients(38.3%).There were no significant differences between the two groups in maternal age,gestational age,time interval between last cesarean section and the current pregnancy,GS diameter,the mean serumβ-hCG levels,myometrium thickness,time forβ-hCG levels normalization.The mean blood loss in the UAE+successful collateral embolization group was significantly less than UAE+failed collateral embolization group.Conclusion During UAE followed by hysteroscopic curettage for the management of CSP,the additional embolization of the collateral is feasible,safe,and may reduce blood bloss related to hysteroscopic curettage.

关 键 词：瘢痕妊娠 子宫动脉栓塞 侧支动脉 介入性放射学 

分 类 号：R714.2[医药卫生—妇产科学] R815[医药卫生—临床医学]