剖宫产子宫瘢痕妊娠的介入治疗评价

The Evaluation on the Intervention Therapy of Cesarean Uterine Sear Pregnancy

目的:对剖宫产子宫瘢痕妊娠的介入治疗—MTX子宫动脉灌注化疗+子宫动脉栓塞术的效果进行评价。方法:将我院2005年1月至2008年1月共8例剖宫产子宫瘢痕妊娠采用以介入治疗为主要方法的结果进行分析。结果:MTX子宫动脉灌注化疗+子宫动脉栓塞术,能快速止血,使胚胎死亡和血β-HCG下降,效果良好。但血β-HCG下降速度不一。血β- HCG<15000 IU/ml者,每48小时下降30-50%;而血β-HCG≥15000 IU/ml者下降缓慢。加行B超引导下胚胎清除术,能使血β-HCG迅速下降,明显缩短住院时间。结论:MTX子宫动脉灌注化疗+明胶海绵栓塞术,是一种有诸多优点,极其有效的治疗方法。如与B超引导下胚胎清除术结合使用,应是最佳治疗手段,值得有条件的医院大力推广。

Objective：The evaluation is based on the intervention therapy of the cesarean uterine scar pregnancy - MTX uterine artery chemotherapy ＋ uterine artery embolization.Methods：The conclusion of an analysis is come out from the eight cases of intervention therapy of uterine scar pregnancy of by Cesarean section which is acted as the main method in our hospital from lanuary 2005 to lanuary 2008.Results：MTX uterine artery chemotherapy＋uterine artery embolization can quickly stop bleeding, so that the embryonic death and blood β -HCG decline,the effective is obvious and very good.But the rate of decline with blood β -HCG is different.The person with blood β -HCG 〈 15000 IU/ml drops 30- 50% per 48-hour,however the patient with the blood β -HCG ≥ 15000 IU/ml drops slowly.Under the guidance of B- ultrasonic to carrying out the embryonic removal, β -HCG blood can be rapidly declining,the patient will be stayed in hospital shortly.Conclusion：MTX chemotherapy uterine artery embolization＋gelatin sponge,which has a lot of advantages with the most effective treatment methods. Such as with the B-ultrasonic guided to remove the embryos,it is the best treatment and be worth to promoted at the good conditional hospital.