子宫动脉化疗栓塞在切口妊娠治疗中的研究

目的探讨子宫动脉化疗栓塞在剖宫产术后子宫切口妊娠治疗中的可行性和安全性。方法回顾分析2006年7月-2011年3月收治的152例剖宫产切口瘢痕妊娠行介入治疗的病例资料。结果 152例子宫动脉化疗栓塞操作均成功。阴道大出血或不规则出血均得到有效控制。人绒毛膜促性腺激素β亚型较术前下降,差异有统计学意义(Z=9.295,P=0.000),术后2～22 d行清宫术,术中失血3～100 mL,平均27 mL。3例行子宫切除术,子宫切除率2%。1例发生栓子脱落导致左下肢胫前动脉栓塞并发症。结论子宫动脉化疗栓塞治疗剖宫产术后切口妊娠可有效控制大出血、降低清宫风险、降低子宫切除风险,是治疗切口妊娠的有效可行方法之一。

Uterine Artery Chemoembolization in the Treatment of Cesarean Scar Pregnancy

Objective To explore the feasibility and safety of uterine artery chemoembolization in the treatment of cesarean scar pregnancy.Methods We retrospectively analyzed the clinical data of 152 patients with cesarean scar pregnancy having undergone uterine artery chemoembolization therapy in our hospital from July 2006 to March 2011.Results All cases of uterine arterial chemoembolization operations were successfully performed with vaginal bleeding and irregular bleeding under effective control.The level of beta human chorionic gonadotrophin was significantly decreased compared with that before the operation(Z= 9.295,P<0.001).Curettage of uterus was carried out within 2 to 22 days after the procedure.The blood loss during curettage procedure was 3-100 mL,averaging 27 mL.Three patients underwent hysterectomy,and the hysterectomy rate was 2%.One case of falling-off embolus led to the complication of left lower extremity anterior tibial artery embolization.Conclusion Uterine artery chemoembolization is a safe and useful procedure for preventing and controlling vaginal bleeding,diminishing the risk of curettage and avoiding the loss of uterus for patients with cesarean scar pregnancy.