子宫动脉栓塞术在治疗子宫瘢痕妊娠中的临床疗效及安全性分析

Efficacy and Safety of Uterine Arterial Embolization in Treatment of Cesarean Scar Pregnancy

目的探讨子宫动脉栓塞术联合清宫术治疗子宫瘢痕妊娠(CSP)的临床疗效及安全性。方法选择2009年1月至2012年1月来鄂尔多斯市东胜区人民医院妇产科住院治疗的CSP患者64例,按照治疗方式不同分为子宫动脉栓塞术治疗组和药物治疗组,每组32例。其中子宫动脉栓塞术治疗组给予子宫动脉栓塞术+清宫术治疗;药物治疗组给予药物+清宫术治疗。观察两组患者的临床疗效及并发症发生情况。结果子宫动脉栓塞术治疗组患者术中出血量、血人绒毛膜促性腺激素(β-HCG)降至正常时间、子宫恢复正常形态时间、住院时间及术后血β-HCG水平与药物治疗组相比,差异有统计学意义(t=9.56、8.43、9.42、6.56、7.36,P<0.01),而两组患者治疗费用比较无统计学意义(t=2.53,P>0.05);子宫动脉栓塞术治疗组患者未发生大出血等严重并发症,且治疗前后性激素水平无显著改变。结论子宫动脉栓塞术联合清宫术治疗CSP安全有效,值得临床推广应用。

Objective To study the efficacy and safety of uterine arterial embolization in treatment of cesarean scar pregnancy （CSP）.Methods Taking 64 cases of CSP during Jan.2009 and Jan.2012 admitted to People＇s Hospital in Dongsheng District as study samples,which were equally divided into two groups by the method of random number table,i.e.32 cases in each group.The uterine artery embolization group was given uterine artery embolization and curettage,while the drug therapy group was given the complete curettage of uterine cavity after using drug therapy,and the clinical efficacy and complications of the two groups were observed.Results The amount of bleeding,blood β-HCG recovery,ultrasound uterus restoration,hospital stay,postoperative bloodβ-HCG levels of the treatment group were significantly different from that of the control group （t =9.56,8.43,9.42,6.56,7.36,P ＜ 0.01）,the treatment expenses of the two groups was not statistically significantly different（t =2.53,P ＞0.05）.Patients in the treatment group did not have serious hemorrhage and other serious complications,and sex hormone levels did not have obvious changes after treatment.Conclusion Uterine artery embolization combined with curettage treatment of CSP is safe and effective,which is worthy of clinical application.