摘要
目的探讨双侧子宫动脉化疗栓塞术结合腹腔镜监测下清宫术在剖宫产瘢痕妊娠保守治疗中的作用。方法对10例剖宫产瘢痕妊娠患者行双侧子宫动脉氨甲喋呤灌注化疗及明胶海绵颗粒栓塞术,术后第1～3天行腹腔镜监测下清宫术。术后复查血HCG及阴式超声。出院后随访血HCG。结果清宫术中患者出血量5～30ml。住院天数5～9天。10例患者清宫术后2天血HCG下降均>90%,术后2～3天复查超声,9例宫内无异常回声,1例超声示宫腔内有残留,中药治疗7天后复查超声宫内无异常回声。术后3～4周10例患者血HCG恢复正常,术后25～40天月经复潮。结论双侧子宫动脉化疗栓塞术结合腹腔镜监测下清宫术能快速终止剖宫产瘢痕妊娠,有效防止子宫破裂、大出血等严重并发症,保留患者子宫,是安全有效的治疗方法。
Objective To evaluate the effect of bilateral uterine artery chemoembolization combined with uterine curettage under laparoscopic monitor in cesarean scar pregnancy （CSP）. Methods Totally 10 patients with CSP who received bilateral uterine artery chemoembolization with Methotrexate and gelfoam particles or PVA were enrolled. Uterine curettage under laparoscopic monitor was performed 1 to 3 days after chemoembolization. Postoperative examination included serum HCG and vaginal ultrasound. Serum HCG follow-up examination was performed after discharge. Results The intraoperative blood loss was 5—30 ml. Hospitalization days was 5—9 days. Serum HCG in all patients decreased above 90% after uterine curettage 2 days. Ultrasonography was performed after 2 or 3 days. No intrauterine abnormal echo was found in 9 patients. Intrauterine residue was found in the other patient,and no intrauterine abnormal echo was found after 7 days＇ TCM treatment. Serum HCG in all patients recovered to normal during 3 to 4 weeks after operation,and menstruation recovered after 25—40 days. Conclusion Bilateral uterine artery chemoembolization combined with uterine curettage under laparoscopic monitor is an effective and safe uterus-preserved therapy for cesarean scar pregnancy,being able to terminate pregnancy rapidly,prevent uterine rupture and severe postpartum hemorrhage effectively.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第12期2364-2366,共3页
Chinese Journal of Medical Imaging Technology
关键词
化学栓塞
治疗性
腹腔镜
清宫术
剖宫产
瘢痕妊娠
Chemoembolization
therapeutic
Laparoscopy
Uterine curettage
Cesarean section
Scar pregnancy
