摘要
目的探讨子宫动脉栓塞术(UAE)联合清宫术在治疗子宫下段剖宫产瘢痕妊娠(CSP)中的价值。方法回顾性分析46例剖宫产瘢痕妊娠患者的临床资料和治疗情况,观察其治疗效果。结果 46例患者均治愈并保留子宫,治疗成功率为100%。42例为内生型剖宫产瘢痕妊娠,行子宫动脉栓塞术+清宫术后2周复查阴道彩超子宫恢复正常,血清人绒毛膜促性腺激素(HCG)均于术后20～45 d降至正常,阴道流血持续时间25～36 d。3例患者行子宫动脉栓塞术联合清宫术后子宫瘢痕处仍有包块,故采取经腹剖宫产瘢痕妊娠病灶清除术, 1例疑子宫瘢痕处不全破裂的患者行子宫动脉栓塞后再行经腹剖宫产瘢痕妊娠病灶清除术联合子宫瘢痕修补术。术后血HCG恢复正常时间为(15±3)d,阴道彩超显示子宫恢复正常时间为(22±7)d。结论子宫动脉栓塞术联合清宫术是治疗内生型剖宫产瘢痕妊娠的理想方法。
Objective To discuss the value of uterine artery embolization(UAE) combined with uterine curettage in the treatment of cesarean scar pregnancy(CSP) after cesarean section of lower uterus. Methods The clinical data and treatment of 46 cases of cesarean scar pregnancy were retrospectively analyzed, and the treatment effect was observed. Results All 46 cases were cured and retained uterus, with success rate as 100%. 42 cases of endogenous cesarean scar pregnancy were treated with uterine artery embolization and uterine curettage, and the uterus returned to normal by color Doppler ultrasound 2 weeks after operation. The serum human chorionic gonadotropin(HCG) decreased to normal 20~45 d after operation, and the duration of vaginal bleeding was 25~36 d. 3 patients underwent uterine artery embolization combined with cesarean section for scar pregnancies because there were still lumps in the scar of uterus after uterine curettage. 1 suspected case of incomplete rupture of uterine scar underwent uterine artery embolization followed by abdominal cesarean section scar pregnancy lesion clearance combined with uterine scar repair. Postoperative blood HCG returned to normal time was(15±3) d, and vaginal color Doppler ultrasound showed that uterus returned to normal time was(22±7) d. Conclusion Uterine artery embolization combined with uterine curettage is an ideal method for the treatment of endogenous cesarean scar pregnancy.
作者
毛雪宝
吕俊
MAO Xue-bao;LIU Jun(Department of Gynaecology, Xianning Central Hospital, First Affiliated Hospital of Hubei University of Science and Technology, Xianning 437100, China)
出处
《中国实用医药》
2019年第10期29-31,共3页
China Practical Medicine
关键词
子宫动脉栓塞术
清宫术
剖宫产瘢痕妊娠
Uterine artery embolization
Hysterectomy
Cesarean scar pregnancy
