文章摘要

子宫动脉栓塞术治疗子宫切口处妊娠的疗效

作者: 1殷明珠, 1郑贤芳
1 安徽医科大学附属巢湖医院妇产科,合肥 238000
通讯: 郑贤芳 Email: 1679978825@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.08.013

摘要

目的:探讨子宫动脉栓塞术+清宫术在治疗子宫切口处妊娠(cesarean scar pregnancy,CSP)患者中的有效性和安全性。方法:回顾性分析安徽医科大学附属巢湖医院2015年1月至2018年11月期间75例子宫切口处妊娠治疗方法,其中介入组49例,行栓塞+清宫;非介入组26例,行药物(米非司酮,氨甲蝶呤)+清宫。对比两组临床疗效,探讨该方法的有效性及安全性,以及对生育功能的影响。结果:两组的停经时间、年龄、血β-hCG比较差异均无统计学意义(均P>0.05)。两组的治疗费用、住院时间、术中出血量、手术成功率、术后月经量有无减少、术后β-hcg值下降至术前一半的时间比较差异均有统计学意义(均P<0.001)。两组月经复潮时间比较差异有统计学意义(P=0.001)。两组再次妊娠比较差异无统计学意义(P=1.000)。结论:子宫动脉栓塞术+清宫术在治疗CSP患者中是能显著降低大出血的风险,提高手术成功率,但对生育功能可能存在一定的负面影响,对有生育要求的患者应谨慎使用。
关键词: 子宫切口处妊娠;介入治疗;生育功能;手术成功率

Efficacy of uterine artery embolization in the treatment of cesarean scar pregnancy

Authors: 1YIN Mingzhu, 1ZHENG Xianfang
1 Department of Obstetrics and Gynecology, Chaohu Hospital of Anhui Medical University, Hefei 238000, China

CorrespondingAuthor: ZHENG Xianfang Email: 1679978825@qq.com

DOI: 10.3978/j.issn.2095-6959.2020.08.013

Abstract

Objective: To investigate the efficacy and safety of uterine artery embolization plus uterine cleaning in the treatment of cesarean scar pregnancy (CSP). Methods: Seventy-five cases of CSP between January 2015 and November 2018 in Chaohu Hospital Affiliated to Anhui Medical University were retrospectively analyzed. The patients were divided into an intervention group (n=49), treated by embolization + uterine cleaning; and a non-intervention group (n=26), treated by drugs (mifepristone, methotrexate) + uterine cleaning. The clinical efficacy, the effectiveness and safety of the method, and the impact on the fertility function were analyzed. Results: There was no significant difference in the time of menopause, age, blood β-hCG between the two groups (P>0.05). The treatment cost, hospitalization time, intraoperative bleeding volume, success rate of operation, reduction of menstrual volume, and reduction of β-hCG value to half of the time before operation were significantly different between the two groups (P<0.001). There was statistical difference between the two groups in menstrual recovery time (P=0.001). There was no significant difference between the two groups (P=1.000). Conclusion: Uterine artery embolization plus uterine cleaning can significantly reduce the risk of massive hemorrhage and improve the success rate of operation in the treatment of CSP patients, but it may have a certain negative impact on the fertility function, and should be used carefully for patients with fertility requirements.
Keywords: cesarean scar pregnancy; interventional therapy; reproductive function; success rate of operation