经子宫动脉途径介入治疗子宫切口妊娠的效果观察

目的探讨经子宫动脉途径介入治疗子宫切口妊娠的可行性和临床疗效。方法采用介入方法治疗13例子宫切口妊娠患者。经双侧子宫动脉超选择性插管,再经动脉导管行超选择性子宫动脉内灌注甲氨蝶呤(MTX)150～200mg,最后以明胶海绵颗粒栓塞子宫动脉。结果 13例患者介入手术均成功,3～5d内在B超引导下行清宫术,术中未见大量出血;8例体温升高,3例下腹部疼痛加剧,1例出现左侧臀部疼痛,在经对症处理后均缓解;随访6个月～4年,13例患者恢复规律月经,4例患者再次怀孕,且足月分娩。结论经子宫动脉途径介入治疗子宫切口妊娠疗效较显著、成功率高,并可预防和控制破裂大出血。

Objective To investigate the feasibility and clinical efficacy of interventional treatment on uterine incision pregnancy. Methods Thirteen patients with uterine incision pregnancy received interventional treatment. Did ultra-selective intubation by bilateral uterine artery, then did super-selective uterine artery perfusion of methotrexate （MTX）150-200mg by patent ductus arteriosus, did embolization uterine artery by gelatin sponge particles. Results Thirteen patients underwent uterize artery embolization all successed, then artificial abortion was performed under B-ultrasonic within 3-5 days, none of them had heavily hemorrhage; 8 cases of body temperature elevated, 3 cases of abdominal pain intensified, 1 cases of left hip pained, after symptomatic treatment were relieved; Thirteen patients were fowllowed-up 6 months to 4 years, all patients resumed rule catamerine, 4 patients were pregnant again, and was the term delivery. Conclusion Transcatheter uterine artery intervention is effective with highly successful rate and has little side effects for the treatment of uterine scar pregnancy.It can prevent and control fatal bleeding induce by pregnancy cyst rupture.