子宫动脉灌注联合PVA栓塞治疗剖宫产瘢痕妊娠临床分析

目的分析子宫动脉灌注MTX联合PVA栓塞治疗剖宫产瘢痕妊娠的临床效果。方法对12例剖宫产瘢痕妊娠患者,行双侧子宫动脉MTX灌注联合PVA栓塞治疗。先经导管向子宫动脉灌注MTX,再用500～710μm PVA颗粒对双侧子宫动脉进行栓塞。通过治疗前后患者的临床表现和血清β-HCG水平及妊娠囊变化情况进行疗效评价。结果 12例患者经子宫动脉灌注MTX联合PVA栓塞治疗后临床症状明显缓解,血清β-HCG水平迅速下降,妊娠囊逐渐萎缩、坏死、脱落。结论子宫动脉灌注MTX联合PVA栓塞治疗剖宫产瘢痕妊娠能迅速止血,有效杀胚,保留子宫,是剖宫产瘢痕妊娠的一种安全、有效治疗方法。

Uterine artery methotrexate infusion combined with PVA embolization for the treatment of cesarean scar pregnancy

Objective To evaluate uterine artery methotrexate infusion combined with PVA embolization in treating cesarean scar pregnancy.Methods Bilateral uterine artery methotrexate infusion combined with PVA embolization was performed in 12 patients with cesarean scar pregnancy.Bilateral uterine artery was infused with methotrexate and then embolized with 500~710 μm PVA.The patients’ clinical manifestation,serum β-human chorionic gonadotropin(β-hCG) level and the changes of the gestational sac of pretherapy and post-treatment were observed and analyzed.Results After uterine artery methotrexate infusion combined with PVA embolization,all of 12 patients’ clinical symptoms were obviously relieved,serum β-human chorionic gonadotropin(β-hCG) level was rapidly descended,the gestational sac was gradually atrophy,necrosis and even desquamate.Conclusion Uterine artery methotrexate infusion combined with PVA embolization is an effective and safe treatment for cesarean scar pregnancy,which can stanch speedly,kill embryo effectively and preserve fertility function.