双侧子宫动脉化疗栓塞术治疗剖宫产子宫切口妊娠

目的探讨双侧子宫动脉化疗栓塞术治疗剖宫产子宫切口妊娠的临床应用价值。方法 2004年3月2009年10月确诊剖宫产子宫切口妊娠的患者25例。首先行双侧子宫动脉超选择插管,注入甲氨喋岭,再用明胶海绵条栓塞双侧子宫动脉,48～72h内在B型超声监测下行清宫术。结果 25例子宫动脉化疗栓塞术后复查B型超声,提示孕囊血供明显减少。22例在B型超声监测下一次性清除胚胎组织,出血量少;2例因胚胎植入肌层突向浆膜层栓塞术后加用氟尿嘧啶,未行清宫,自行排出;1例因术后切口处形成大血肿行手术治疗。结论双侧子宫动脉化疗栓塞术是治疗剖宫产子宫切口妊娠一种有效方法,既保留子宫,又保留其生育功能。

Clinical Analysis on Bilateral Uterine Artery Chemoembolization for Caesarean Scar Pregnancy

Objective To evaluate the application of bilateral uterine artery chemoembolization for caesarean scar pregnancy（CSP）.Methods A total of 25patients with CSP From March 2004to October 2009were selected.Bilateral uterine artery super selective catheterization was performed after injection with methotrexate,and gelatin sponge granules were injected into blateral uterine artery.Then atificial abortion was performed under B-ultrasonic scanning within 48-72hours.Results In all 25cases,the blood flow of the embryo decreased significantly after uterine artery chemoembolization.A total of 22patients received artificial abortion successfully with little vaginal bleeding;two pateints received medication with 5-FU duet to the embryo near to the perimetrium,and finally the embryo expulsed spontaneously;one patient underwent hysterectomy,because a huge hematoma was formed at the incision of the uterus after uterine artery chemoembolization.Conclusion Bilateral uterine artery chemoembolization is effective for CSP,which could keep the uterus and the patients＇reproductive function.