子宫动脉化疗栓塞术联合刮宫术治疗剖宫产瘢痕妊娠的临床疗效

目的探讨子宫动脉化疗栓塞术联合刮宫术治疗剖宫产瘢痕妊娠(CSP)的可行性和安全性。方法将82例CSP患者分为2组:A组39例,行氨甲蝶呤+刮宫术;B组43例,行子宫动脉化疗栓塞术+刮宫术。比较2组刮宫术成功率、术中出血量、β-HCG下降至正常的时间、住院时间及术后6个月性激素水平和月经周期恢复时间等。结果 A组中4例因无法控制的急性阴道出血而终止刮宫术,对其中2例行子宫切除手术,2例行子宫动脉栓塞术止血。B组无子宫切除患者。刮宫术成功率、术中出血量、β-HCG下降至正常的时间、住院时间在两组间差异均有统计学意义(P均0.05),但术后6个月性激素水平和月经周期恢复时间组间差异无统计学意义(P均0.05)。结论子宫动脉化疗栓塞术联合刮宫术治疗CSP安全、有效,可明显降低子宫切除风险。

Therapeutic effect of uterine artery chemoembolization combined with curettage in treatment of cesarean scar pregnancy

Objective To observe the feasibility and safety of uterine artery chemoembo!ization （UACE） combined with dilatation and curettage in treatment of cesarean scar pregnancy （CSP）. Methods A total of 82 patients with CSP were en- rolled and divided into group A （n=39） and group B （n=43）. Patients in group A received methotrexate＋curettage, and patients in group B received additional UACE＋curettage. The success rate of operation, the blood loss during operation, the time taken for ~l-human chorionic gonadotrophin （{~-HCG） level going down to normal, the hospitalization days, the menstrual situation and sex hormone level after operation six months were compared between two groups. Results In group A, 2 patients had to receive hysterectomy, and 2 patients had to receive uterine artery chemoembolization due to massive hemorrhage. No patient in group B needed to undergo hysterectomy. The success rate of operation, the blood loss during the operation, the time taken for β-HCG level going down to normal, the hospitalization days were statistically dif- ferent （all P〈0.05）, but no significant difference of menstrual situation and sex hormone level after operation 6 months was found between the two groups （all P〈0.05）. Conclusion UACE combined with curettage is safe and effective for the treatment of cesarean scar pregnancy, being helpful to avoid ureterectomy.