血管内介入治疗子宫特殊部位妊娠

目的探讨血管内介入治疗在子宫特殊部位异位妊娠治疗中的临床意义。方法对22例子宫特殊部位妊娠患者行双侧子宫动脉灌注氨甲蝶呤加栓塞术治疗,其中宫颈妊娠6例、子宫切口妊娠15例、宫角妊娠1例,分析其临床疗效。结果 20例经子宫动脉栓塞术后血β-HCG水平呈进行性显著下降,2～3周均降至正常。6例因仍有少量阴道出血及妊娠物残留,于术后5～19天行清宫术,无子宫破裂和大出血发生,随访2个月后月经周期均恢复正常。结论血管内介入治疗子宫特殊部位异位妊娠微创、安全有效、并发症少,可保留患者子宫及生育功能。

Endovascular intervention for the treatment of ectopic pregnancy in special parts of uterine

Objective To observe the clinical significance of endovascular interventional treatment for pregnancy in special parts of uterine. Methods Twenty-two patients with pregnancy in special parts of uterine underwent bilateral uterine artery infusion of methotrexate （MTX） combined with uterine artery embolization. Among 22 patients, there were 6 cases of cervical pregnancy, 15 of uterine incision pregnancy, and 1 case of uterine horn pregnancy. Clinical efficacy of this treatment was evaluated. Results After endovascular interventional therapy, β-HCG levels in 20 patients significantly decreased, and returned to normal in 2 to 3 weeks. Six patients underwent curettage 5 to 19 days after intervention because of fleabite vaginal bleeding and residual pregnancy, no uterine rupture and hemorrhage occurred, and the menstrual cycle returned to normal in 2 months. Conclusion Endovascular interventional treatment of pregnancy in special parts of uterine is minimally invasive, safe and effective, with fewer complications, able to preserve uterus and procreation functions.