子宫动脉介入栓塞化疗术在特殊部位妊娠治疗中的应用研究

Research at Intervention of Uterine Artery Chemoembolization in the Treatment of Specific Parts of Pregnancy

目的:探讨子宫动脉介入栓塞化疗术(UACE)在特殊部位妊娠治疗中效果,减少终止妊娠式治疗的危害性。方法:将72例特殊部位妊娠患者按治疗方式分为两组,对照组36例在给予米非司酮、甲氨蝶呤杀胚后实施清宫术,实验组36例实施UACT,比较两组术中出血量、月经恢复及宫腔输卵管畅通情况等。结果:实验组术中出血量为(73.2±18.9)mL,少于对照组(112.5±32.4)mL(P<0.05);两组血β-HCG、月经周期恢复正常时间比较差异无统计学意义(P>0.05);实验组子宫输卵管造影显示输卵管畅通率为91.67%,高于对照组的72.22%(P<0.05);对照组4例术中大出血,3例子宫穿孔,刮宫相关并发症发生率为19.44%,实验组无1例发生大出血及子宫穿孔。结论:UACE是治疗特殊部位妊娠的有效方法,可保留卵巢及输卵管的生理、解剖功能,安全、可靠,可作为特殊部位妊娠的首选保守治疗方法。

Objective： To investigate the effect of uterine artery chemoembolization （UACE） in the treatment of specific parts of pregnancy, to reduce the dangers. Method： 72 cases of special parts of pregnancy were divided into 2 groups according to the treatment , 36 cases in the control group were given mifepristone , methotrexate after killing embryos implementation curettage, while 36 cases in the test group implemented UACT, compared intraoperative bleeding, menstruation and uterine tubal smooth. Result： The blood loss in the test group was （73.2±18.9} mL, less than that in the control group （112.5±32.4） mL （P 〈0. 05） ;blood β-HCG, restore normal menstrual cycle time between two groups showed no statistically significant {P〉0.05） ; hysterosalpingography display tubal smooth in the test group was 91.67 % ,which was higher than in the control group（72.22% ）（P〈0.05 } ; 4 cases in the control group of intraoperative bleeding, 3 cases of uterine perforation, curettage associated morbidity 19.44 %, nobody bleeding and uterine perfora-tionin in the test group. Conclusion： UACE special parts of pregnancy is an effective method of treatment, It can keep the ovaries and fallopian tubes physiological , anatomical features, safe, reliable , It＇s a conservative treatment method of choice as a special part of pregnancy.