子宫动脉灌注化疗联合栓塞术在瘢痕妊娠治疗中的疗效

目的：探讨经子宫动脉灌注甲氨蝶呤联合栓塞治疗剖宫产术后瘢痕妊娠的临床疗效。方法选取2009年9月至2015年3月收治的33例瘢痕妊娠患者，随机分成两组，观察组18例，对照组15例，观察组经子宫动脉灌注50 mg甲氨蝶呤稀释液，灌注完毕用明胶海绵栓塞子宫动脉。对照组仅栓塞子宫动脉，术中未行甲氨蝶呤灌注，而采用入院后直接给予甲氨蝶呤50 mg／ m2肌肉注射。结果两组患者介入栓塞治疗成功率为100％，所有患者术后1、2周β-HCG水平均有明显降低。β-HCG水平下降程度、清宫过程中出血量观察组明显优于对照组（P ＜0.05）。观察组患者的住院时间亦短于对照组（P ＜0.05）。结论经子宫动脉灌注化疗联合栓塞术治疗剖宫产术后瘢痕妊娠具有创伤小、恢复快等优点，术后可有效降低清宫时出血量，缩短患者住院时间。

Evaluation of efficacy of uterine arterial infusion chemotherapy combined with embolization in treatment of cesarean scar pregnancy

Objective To investigate the clinical efficacy of uterine arterial infusion of methotrexate combined with embolization for cesarean scar pregnancy. Methods Thirty-three cases diagnosed as cesarean scar pregnancy from September 2009 to March 2015 in our hos-pital were selected and divided into two groups randomly. The observation group received uterine arterial infusion of 50mg methotrexate dilu-tions then gelatin sponge embolization uterine artery,while the control group was treated with only embolization uterine artery,without infu-sion of methotrexate,and for these patients,we used methotrexate 50 mg/ m2 intramuscular injection after admission. Results The emboliza-tion success rate was 100% in two groups. The β-HCG levels were significantly reduced in all patients after postoperative one week and two weeks. The degree of decline in β-HCG levels of the observation group was faster than that of the control,and the amount of bleeding during postoperative curettage was less than that in the control(P < 0. 05). Hospitalization time of the observation group was also shorter than that of the control group (P < 0. 05). Conclusion Uterine arterial infusion chemotherapy combined with embolization in the treatment of cesarean scar pregnancy have the advantages of less damage and faster recovery and so on. Moreover,it can reduce the amount of bleeding during post-operative curettage effectively and shorten hospitalization time.