摘要
目的探讨子宫动脉栓塞治疗在子宫瘢痕妊娠中的临床应用价值。方法 2007年11月-2010年2月收治子宫下段剖宫产术后子宫瘢痕妊娠11例,其中4例因阴道大出血入院后急诊行子宫动脉栓塞治疗;另7例患者行MTX静脉化疗(每天剂量为0.4 mg/kg,5 d为1个疗程),其中3例患者在化疗期间因突发阴道大出血(出血量≥100 ml/h)而急诊行子宫动脉栓塞治疗;4例患者给予MTX静脉化疗2个疗程,血HCG无明显下降而进一步行子宫动脉栓塞治疗。结果 11例介入治疗患者术后血HCG均下降明显,7例阴道大出血患者于术后半小时内阴道流血明显减少,11例均保留子宫成功,完整保留生育能力。结论子宫动脉栓塞治疗对子宫瘢痕妊娠合并有阴道大出血(>500 ml/24 h)及(或)血β-HCG异常升高(血β-HCG≥20 000 IU/L)、异位妊娠肿块直径≥5 cm的患者疗效显著,能很好保留女性生育功能,减少切除子宫风险,有临床应用价值。
Objective To evaluate uterine artery embolization in treating uterine scar pregnancy.Methods During the period from November 2007 to February 2010,11 patients with uterine scar pregnancy were encountered in authors＇ hospital.All the patients had a history of lower uterine segment cesarean section.Four patients had to receive an emergency uterine artery embolization due to acute massive vaginal bleeding.The other 7 patients received intravenous chemotherapy with MTX（0.4 mg/kg/day,every 5 days as a treatment course）.Emergency uterine artery embolization had to be carried out in three patients as they developed acute massive vaginal bleeding（blood loss ≥ 100 ml/hour） during the course of chemotherapy,while subsequent uterine artery embolization was performed in the remaining 4 patients after they had completed two courses of treatment when their blood HCG showed no significant decrease.The clinical results were analyzed.Results Remarkable decrease in serum HCG was seen in all 11 patients after interventional management.The vaginal bleeding in 7 patients was significantly reduced within half an hour after uterine artery embolization.The uterus together with intact fertility was successfully preserved in all 11 patients.Conclusion For the treatment of uterine scar pregnancy complicated by massive vaginal bleeding（blood loss ≥ 500 ml/24 h） and/or abnormal elevation of serum HCG（blood β-HCG ≥ 20 000 IU/L）,ectopic pregnancy with the mass diameter ≥ 5 cm,uterine artery embolization treatment is very safe and effective.This technique can well preserve female patient＇s uterus and fertility ability.It is of value to employ this treatment in clinical practice.
出处
《介入放射学杂志》
CSCD
北大核心
2011年第11期898-900,共3页
Journal of Interventional Radiology
关键词
子宫瘢痕妊娠
介入治疗
子宫动脉栓塞
uterine scar pregnancy
interventional treatment
uterine artery embolization
