子宫动脉栓塞后刮宫治疗子宫切口妊娠的临床观察

目的探讨子宫动脉栓塞后刮宫治疗子宫切口妊娠的临床应用价值。方法将58例子宫切口妊娠患者按入院先后顺序随机分为观察组、对照组,每组29例。观察组在双侧子宫动脉栓塞术后行刮宫术;对照组在MTX肌内注射后行刮宫术。对出血量、住院时间、血β-HCG下降至正常时间、不良反应等临床指标进行比较。结果观察组和对照组出血量分别为（204.7±100.0）ml和（448.5±130.3）ml;血HCG降至正常的时间分别为（47.6±6.4）d和（72.6±11.5）d;住院时间分别为（7.9±2.4）d和（36.7±11.1）d,组间比较具有显著性差异（P〈0.05）;在不良反应方面,组间比较差异无显著性（P〉0.05）。结论子宫动脉栓塞后刮宫治疗切口妊娠优于MTX肌内注射后行刮宫术,具有降低大出血风险,保留妇女生育功能,疗效确切,安全、副反应轻的优点,值得临床推广应用。

Curettage after uterine artery embolization in treatment of cesarean scar pregnancy

Objective To explore the clinical value of curettage after uterine artery embolization(UAE)in treatment of the cesarean scar pregnancy(CSP).Methods By order of admission,58 patients with CSP were randomly divided into observation group and control group(n=29).Observation group was underwent curettage after UAE and control group was underwent curettage after intramuscular injection of MTX-line.The clinical indicators after treatment were compared between the two groups including the amount of bleeding,hospitalization time,serum β-HCG dropped to normal time,adverse reactions etc.Results For all clinical indicators of observation group and control group,bleeding amount are(204.7±100.0) ml &(448.5±130.3) ml;serum HCG dropped to normal time are(47.6±6.4) d &(72.6±11.5) d;hospital stay are(7.9±2.4) d &(36.7±11.1) days,the difference was statistically significant between groups(P<0.05).Adverse events has no significant difference between groups(P>0.05).Conclusions Curettage after UAE is an effective,safe and minimally invasive method with low risk of heavy bleeding in treatment of CSP superior to curettage after intramuscular injection of MTX and has important clinical value.