子宫动脉阻断术与子宫动脉栓塞术在剖宫产瘢痕妊娠手术治疗中的应用研究

目的 探讨先行子宫动脉阻断术与子宫动脉栓塞术在剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)手术治疗中的应用价值.方法 回顾性分析2014年1月—2015年6月诊断为CSP的36例患者,其中24例行腹腔镜下子宫动脉阻断术后行剖宫产瘢痕病灶切除修补术为子宫动脉阻断组,12例行子宫动脉栓塞术后行腹腔镜下剖宫产瘢痕病灶切除修补术为子宫动脉栓塞组.比较两组术中出血量、住院时间以及术后血β-人绒毛膜促性腺激素(β-hu-man chorionic gonadotropin,β-HCG)恢复至正常的时间.结果 36例CSP患者均经手术治疗成功,未发生术中及术后并发症.两组的术中出血量和血β-HCG恢复至正常的时间比较差异均无统计学意义(P>0.05);子宫动脉阻断组住院时间较子宫动脉栓塞组短(P<0.01).结论 子宫动脉阻断术是CSP手术治疗中的一种安全、有效且较为经济的预处理方法.

An Application Study between Uterine Artery Interruption and Uterine Artery Embolization in Surgical Treat-ment of Caesarean Scar Pregnancy

Objective To investigate clinical value of uterine artery interruption and uterine artery embolization in surgical treatment of patients with caesarean scar pregnancy ( CSP) . Methods Clinical data of 36 CSP patients ad-mitted during January 2010 and December 2014 was retrospectively reviewed. The 24 patients underwent excision and re-pair for cesarean section scar after uterine artery interruption under laparoscopes ( uterine artery interruption group ) , while other 12 cases underwent excision and repair for cesarean section scar after uterine artery embolization ( uterine ar-tery embolization group) . Intraoperative blood loss, hospital stay and recovering to normal time of postoperative bloodβ-human chorionic gonadotropin (β-HCG) were compared between the two groups. Results All operations for CSP pa-tients were successful without intraoperative and postoperative complications. There were no significant differences in val-ues of intraoperative blood loss and recovering to normal time of postoperative bloodβ-HCG between the two groups ( P>0. 05). The hospital stay in uterine artery interruption group was shorter than that in uterine artery embolization group (P<0. 01). Conclusion Uterine artery interruption is a safe, effective and economical pretreatment method in surgical treatment of caesarean scar pregnancy.