子宫动脉灌注化疗加栓塞术治疗宫颈妊娠及切口妊娠

目的：探讨子宫动脉灌注化疗加栓塞术治疗宫颈妊娠及剖宫产后切口妊娠的临床效果。方法宫颈妊娠患者9例，剖宫产后切口妊娠8例患者，采用Selding方法，经皮股动脉穿刺，放置患者双侧子宫动脉内并注射甲氨蝶呤、5-Fu，再使用明胶海绵颗粒对双侧子宫动脉进行栓塞。结果1例因急性大出血行急诊介入治疗，阴道流血即行停止。9例宫颈妊娠患者均在予以子宫动脉栓塞术后3～8 d行人工流产术，术中出血量10～30 mL；全部患者血β-HCG术后均明显下降；8例剖宫产后切口妊娠患者术后3～12 d行彩色多普勒检查，证实胎芽胎心消失，未再行处理。介入治疗术后无严重并发症发生。结论子宫动脉灌注化疗加栓塞术治疗对宫颈妊娠及剖宫产后切口妊娠患者既能快速诊断、及时止血、又有良好的治疗效果，同时保留了子宫的完整和其生育功能。

Uterine arterial infusion chemotherapy combined with embolization for cervical pregnancy and cesarean scar preg-nancy

Objective To explore clinical effect of using uterine arterial infusion chemotherapy and embolization to cure cervical pregnancy and cesarean scar pregnancy （CSP）.Methods 9 cases of cervical pregnancy patients and 8 cases of CSP patients accepted percutaneous femoral artery puncture .Methotrexate（MTX） and 5 Fluorouracil （5-Fu） were injected into two sides＇uterine arterial and gelfoam particles were used to embolize them .Results One case accepted emergency interventional treatment because of acute massive hemorrhage .Vaginal bleeding ceased immediately .The 9 cervical pregnancy patients under-went artificial abortion 3~8 days after uterine arterial embolization ,with blood loss ranging from 10 to 30ml.β-HCG of all the patients decreased obviously after treatment .3 to 12 days after the treatment , the 8 patients with CSP were examined by color Doppler.It showed that fetal heart rate disappeared and no further treatment was followed .No serious complications occurred after interventional therapy .Conclusion For patients with cervical pregnancy and CSP ,uterine arterial infusion chemotherapy combined with embolization can ensure rapid diagnosis , timely hemostasis and sound therapeutic effect .It also contributes to preserving complete uterus and reproductive function .