子宫动脉栓塞术联合 B 超引导下清宫术治疗剖宫产疤痕妊娠的应用研究

摘要

Aim:To investigate the clinical application of uterine arterial embolization therapy com-bined with ultrasonography-guided suction curettage for treatment of Cesarean scar pregnancy.Methods:Uterine arterial embolization therapy was performed in 47cases of Cesarean scar pregnancy.Ultrasonogra-phy-guided suction curettage was carried out within 24 hours afterwards.Results:Uterine arterial emboli-zation therapy combined with ultrasonography-guided suction curettage was performed successfully in all cases with minimal bleeding during the operations.All cases who accepted uterine arterial embolization therapy combined with ultrasonography-guided suction curettage had healed including two patients with additional treatment of MTX chemotherapy and two of hysteroscopic residue electroexcision additionally. Normal menstruation was recovered in all patients after the treatment.No hysterectomy,infections and se-vere complications occur in the study.Conclusion:With the advantages such as mini-invasive,few com-plications and retention of uterus,uterine arterial embolization therapy combined with ultrasonography-guided suction curettage could be an effective and safe treatment for Cesarean scar pregnancy.%目的：探讨子宫动脉栓塞术联合 B 超引导下清宫术治疗剖宫产疤痕妊娠的临床价值．方法：对47例剖宫产疤痕妊娠的患者进行子宫动脉栓塞术，24 h 内在 B 超引导下清宫术，进行回顾性分析．结果：所有病例均一次栓塞成功，清宫术中出血量少．43例经子宫动脉栓塞术联合 B 超引导下清宫术治愈；2例经后续补充 MTX 治愈；2例经后续补充宫腔镜手术治愈．所有患者成功保留子宫，并恢复正常月经．无感染等严重并发症发生．结论：子宫动脉栓塞术联合 B 超引导下清宫术治疗剖宫产疤痕妊娠手术创伤小、疗效确切、并发症少、能保留子宫，在有条件的医院可作为首选的治疗方法．