子宫动脉栓塞术治疗剖宫产术后子宫疤痕妊娠的临床分析

目的 探讨子宫动脉栓塞术(uterine arterial embolization,UAE)治疗剖宫产术后子宫疤痕妊娠(cesarean scar pregnancy,CSP)的临床疗效.方法 收集昆明医科大学第二附属医院2006年6月至2011年6月收治的32例剖宫产术后子宫疤痕妊娠病例,回顾分析子宫动脉栓塞术参与其治疗的临床效果.结果 32例CSP患者中26例直接行子宫动脉栓塞术(UAE)联合甲氨蝶呤(MTX)治疗,栓塞后11例行清宫术,另15例未行清宫,均预后良好；6例行MTX保守治疗,2例HCG降至正常,4例清宫,2例治愈,2例因清宫术中大出血急诊行UAE止血.结论 UAE是一种有效的治疗CSP的方法,且UAE术后不必常规清宫治疗,对于CSP患者清宫过程中发生的大出血,UAE也是一种十分有效的止血方法.

Treatment of Cesarean Scar Pregnancies with Uterine Arterial Embolization

Objective To explore the therapeutic effect of UAE on cesarean scar pregnancies(CSP).Methods The clinical data of 32 CSP in our hospital were retrospectively analysed from 2006 to 2011.The therapeutic effect of UAE on cesarean scar pregnancies was observed.Results 26 cases in 32 patients of CSP were treated with UAE and MTX.Hemorrhage was little in 11 cases who were curettaged after UAE,15 cases were not curettaged.The clinical effect was remarkable.4 cases were curettaged afer medical treatment,2 cases were cured and 2 cases were treated acutely with UAE as hemorrhage.12 cases were treated only with medicines,3 cases in them were crued and 9 cases were cured by UAE.Conclusions UAE is an effective therapeutic method for CSP,and curettage is not necessary after UAE.UAE is also effective for hemorrhage during curettage.