双侧子宫动脉化疗栓塞术治疗剖宫产术后瘢痕妊娠的临床观察

目的:评估双侧子宫动脉化疗栓塞术治疗剖宫产术后瘢痕妊娠(CSP)的临床应用价值。方法:回顾性分析23例CSP患者双侧子宫动脉化疗栓塞前后的临床资料。结果:23例患者中,10例患者因瘢痕妊娠清宫术发生阴道出血而采用急诊子宫动脉化疗栓塞介入治疗;余13例患者采用子宫动脉化疗栓塞序贯超声引导下清宫术治疗。所有发生阴道出血患者于介入术后均停止出血;且介入术后序贯清宫术治疗的患者于清宫术中均未出现大出血并发症。1月后复查,所有患者β-HCG均完全降至正常。结论:UACE术可用于CSP患者清宫术中大出血的紧急治疗;而UACE术序贯超声引导下清宫术治疗可能是一种更为安全有效地治疗CSP的新策略。

Clinical observation on bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy

Objective:To evaluate the clinical application value of bilateral uterine arterial chemoembolization(UACE) for treatment of cesarean scar pregnancy(CSP). Methods:The clinical data of 23 CSP patients before and after bilateral UACE were analyzed retrospectively. Results:Among 23 patients,vaginal bleeding occurred in 10 patients because of uterine curettage,then emergent UACE was adopted;the other 13 patients adopted UACE combined with uterine curettage under the guidance of sequential ultrasound.All the patients with vaginal bleeding stopped bleeding after UACE;massive hemorrhage didn’t occur in the patients during uterine curettage.All the patients were reexamined after one month,and the levels of β-HCG of all the patients decreased to normal levels. Conclusion:UACE can be used for emergent treatment of massive hemorrhage of CSP patients during uterine curettage;UACE combined with uterine curettage under the guidance of sequential ultrasound may be one new strategy for safe and effective treatment of CSP.