子宫动脉栓塞术在剖宫产后子宫切口妊娠中的应用.docVIP

精品论文 参考文献 子宫动脉栓塞术在剖宫产后子宫切口妊娠中的应用 詹平 刘玲 范凌晔 毛熙光（通讯作者） 　　(泸州医学院附属医院妇产科 646000) 　　【摘要】目的 探讨子宫动脉栓塞术在剖宫产后子宫切口妊娠中的应用价值。方法 对2005年1月至2013年6月我院收治的104例子宫切口妊娠患者进行回顾性分析，将其分为直接清宫组和介入后清宫组：直接清宫组甲氨蝶呤肌注后行清宫术，介入后清宫组甲氨蝶呤子宫动脉灌注、双侧子宫动脉栓塞术后行清宫术。结果 两组患者清宫时的出血量、手术时间、术后血红蛋白、宫内残留发生率、子宫切除率和平均住院日等进行比较，差异有显著性，介入后清宫组的疗效明显高于直接清宫组。结论 双侧子宫动脉栓塞术治疗子宫切口妊娠，疗效显著，能有效控制和减少出血，保留患者子宫，值得广泛应用。 　　【关键词】子宫动脉栓塞术 子宫切口妊娠 　　【中图分类号】R713.4 【文献标识码】A 【文章编号】2095-1752（2014）11-0081-03 　　Termination of caesarean scar pregnancy by uterine artery embolization combination with methotrexate uterine arterial perfusion 　　Zhan Ping, Liu Ling, FanLing-ye, Mao Xi-guang*. 　　Department of Obstetrics and Gynecology, Affiliated Hospital of Luzhou Medical College. Luzhou, China. 646000 　　【Abstract】Objective: To investigate the efficacy of bilateral uterine artery 　　embolization for the treatment of caesarean scar pregnancy (CSP). Methods: There were 104 patients with caesarean scar pregnancy. They were divided into two groups in random. One group was received uterine curettage after uterine artery embolization (UAE) combined with intra-arterial methotrexate (MTX ) infusion，the other was received uterine curettage after intramuscular MTX. The clinical information on these patients were reviewed. Results:Hemorrhage 　　and time of operation , hemoglobin after curettage, incidence rate of remain and hysterectomia, length of hospital stay were analyzed in two groups. The difference was significantly seen between two groups. Conclusions: Uterine artery embolization seems to be an effective treatment for CSP and should be considered as a good treatment. 　　【Key words】methotrexate uterine arterial perfusion caesarean scar pregnancy 　　子宫切口妊娠（Cesarean scar pregnancy,CSP）是一种少见的异位妊娠[1]，指孕囊或胚胎组织着床在剖宫产后子宫切口瘢痕处。由于该处子宫肌层薄，收缩力差，清宫时容易发生大出血、子宫破裂、膀胱损伤等严重并发症。近年来因剖宫产率增加，子宫切口妊娠发生率有增高趋势，严重威胁到广大妇女的生命安全，是剖宫产术后的远期并发症之一[2]。随着介入技术在妇产科领域的应用，子宫动脉栓塞术已成为治疗子宫切口妊娠的一种有效、安全、快速的方法[3]。本文对2005年1月至2013年6月在我院治疗的