摘要
目的比较子宫动脉灌注化疗栓塞术(UACE)联合宫腔镜和超声导引下囊内注射甲氨蝶呤(MTX)联合宫腔镜治疗剖宫产瘢痕妊娠(CSP)的安全性、疗效及并发症。方法回顾性分析嘉兴市3家医院100例CSP患者病史资料及治疗经过,其中A组50例接受UACE联合宫腔镜清宫术,B组50例接受超声导引下囊内注射MTX联合宫腔镜清宫术,比较治疗效果。结果A组患者UACE手术顺利,术后2~6 d内宫腔镜治疗后患者未出现大出血转开腹手术;B组患者超声导引下孕囊内注射MTX顺利,术后6~8 d宫腔镜治疗后2例出现大出血转开腹手术。A组宫腔镜术中出血量低于B组(P<0.05),住院时间短于B组(P<0.05)。结论UACE联合宫腔镜治疗CSP安全性高,疗效确切,并发症发生率低。
Objective To compare the safety,efficacy and complications of uterine artery chemoembolization(UACE)plus hysteroscopic curettage with those of ultrasound-guided intra-gestational sac methotrexate(MTX)injection plus hysteroscopic curettage in treating cesarean scar pregnancy(CSP).Methods The clinical data and treatment process of 100 patients with CSP,who were collected from three hospitals in Jiaxing City of China,were retrospective analyzed.The patients were divided into group A(n=50,receiving UACE plus hysteroscopic curettage)and group B(n=50,receiving ultrasound-guided intra-gestational sac MTX injection plus hysteroscopic curettage),and the curative effects were compared between the two groups.Results In group A,UACE was successfully accomplished in all patients,which was followed by hysteroscopic curettage in 2-6 days,and no patient had massive bleeding that needed to be transferred to open surgery.In group B,successful ultrasound-guided intra-gestational sac MTX injection was achieved in all patients,which was followed by hysteroscopic curettage in 6-8 days,and 2 patients developed massive bleeding and had to be transferred to open surgery.The volume of blood loss during hysteroscopy in group A was significantly lower than that in group B(P<0.05),and the duration of hospitalization in group A was shorter than that in group B(P<0.05).Conclusion For the treatment of CSP,UACE combined with hysteroscopic curettage is highly safe with reliable curative effect and lower incidence of complications.
作者
周冰
黎良山
韩俊
陈冬冬
ZHOU Bing;LI Liangshan;HAN Jun;CHEN Dongdong(Department of Radiology,Jiaxing Municipal Hospital of Traditional Chinese Medicine,Jiaxing,Zhejiang Province 314001,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第6期574-577,共4页
Journal of Interventional Radiology
关键词
子宫动脉化疗栓塞术
超声导引
甲氨蝶呤
剖宫产瘢痕妊娠
uterine artery chemoembolization
ultrasound guidance
methotrexate
cesarean scar pregnancy
