摘要
目的:探讨双侧子宫动脉灌注化疗加栓塞术对剖宫产术子宫瘢痕妊娠(CSP)的应用价值。方法:将临床确诊的42例CSP患者经双侧子宫动脉灌注化疗药物MTX后行子宫动脉栓塞术(UAE),并在患者生命体征平稳的情况下行清宫术。同时监测UAE术前和术后孕囊大小、双侧子宫动脉CDFI血流结果及血清β-HCG水平,了解该治疗方法的有效性。结果:所有患者均顺利完成UAE手术,清宫术中出血量平均为14 mL,无大出血及误栓塞患者,术后均未发生感染、子宫坏死、穿刺点血肿。所有病例术后1～2月恢复正常月经。1年后5例患者正常怀孕。统计学分析显示UAE术前、术后的孕囊大小、血清β-HCG明显下降,具有极显著性差异(P<0.01)。结论:双侧子宫动脉灌注化疗加栓塞术对治疗CSP是安全的、可行的,能有效减少清宫术中出血,并有保留患者子宫和生育功能的优势。
Objective：To investigate the clinical application of bilateral Trans-uterine arterial Chemotherapy and Embolization in the treatment of cesarean scar pregnancy（CSP）.Methods：Forty-two patients,who were diagnosed as CSP,were included in the study.After the surgery of bilateral uterine artery infusion MTX and uterine arterial embolization（UAE）,these patients received operation of uterine curettage when they vital signs were stable.And we monitored and statistical analyzed the gestational sac size,bilateral uterine artery CDFI findings and levels of serum β-HCG before and after the UAE.Results：All patients had successful completion of UAE operations,had no massive hemorrhage,mistaken thrombosis,and no postoperative infection,uterine necrosis and hematoma puncture.Average blood loss was 14ml in uterine curettage.All cases resumed normal menstruation in two months and 5 patients had normal pregnancy in one year after surgery.Statistical analysis showed that the gestational sac size and serum β-HCG decreased was quite obvious before and after the treatment,and had statistical significance（P0.01）.Conclusion：Bilateral Trans-uterine arterial Chemotherapy and Embolization in treatment of CSP is safe and feasible,and can effective reducing blood loss during uterine curettage.Patients can reserve the uterus and reproductive function.
出处
《现代临床医学》
2011年第3期191-192,共2页
Journal of Modern Clinical Medicine
