子宫动脉栓塞术在急诊瘢痕妊娠中的治疗分析

摘要

目的：探讨近年来的子宫动脉栓塞术(uterine artery embolization，uaE)在治疗剖宫产术后导致的子宫瘢痕妊娠(cesarean scar pregnancy，csP)中的疗效及临床安全性。方法回顾性分析，探讨本院2010年1月至2013年6月75例剖宫产术后瘢痕妊娠患者的诊疗经过资料。结果74例患者行子宫动脉栓塞术成功，3例因大出血急诊行子宫动脉栓塞成功，其中1例不成功行次全子宫切除术。其中40例同时行甲氨蝶呤(mTX)动脉灌注，均在栓塞术后48～72小时行超声介导下刮宫术；74例患者术后随访6～36个月，清宫后无1例再次阴道大出血，均未出现继发性闭经或卵巢早衰。结论 csP早期行uaE治疗，有效保留子宫，提高生活质量，能明显减少出血量，是治疗csP安全、有效的方法。%ObjectiveTo investigate the clinical analysis of uterine artery embolization in the cases of cesarean scar pregnancy.Method 75 cases of cesarean scar pregnancy in fujian Provincial Hospital from January 2010 to June 2013 were included,and their clinical data were analyzed to summarize treatment experience.Result 74 cases of cesarean scar pregnancy succeeded in uterine artery embolization, and 40 cases succeeded in mTX uterine artery embolization, and the curettages were done after 48~72 hours. 3 cases succeeded in emergency uterine artery embolization.1 case did not succeed and was done by subtotal hysterectomy. amenorrhoea or ovarian failure were not present in 74 cases 6~36 months after operation. Conclusion The early uterine artery embolization in the cases of scar pregnancy is safe and highly recommended.