宫腔镜联合子宫动脉栓塞术在剖宫产切口斑痕妊娠中的应用

Hysteroscopy combined with uterine artery embolization in treating cesarean scar pregnancy

目的：分析宫腔镜联合子宫动脉栓塞术（UAE）在治疗剖宫产切口瘢痕妊娠（CSP ）中的效果．方法：选取我院2011／2013收治的20例剖宫产切口瘢痕妊娠患者进行分析，在治疗前使用UAE联合甲氨蝶呤注入动脉，当患者血β-HCG降至1000 U／L左右，超声检查显示病灶浆膜层厚为0．2 cm以上时，行腹腔镜手术切除病灶．结果：所有患者宫腔镜手术持续时间为20～41（平均22．3±3．5）min，术中出血量为（18．2±5．7）mL，所有患者无术中转开腹，术中无并发症等情况发生，患者血β-HCG在术后降至（113．7±35．2）U／L，术后（40．2±2．5）d恢复月经．结论：利用宫腔镜联合子宫动脉栓塞术（UAE）在治疗剖宫产切口瘢痕妊娠（CSP）能得到满意的治疗效果，为有效的治疗方法．

AIM：To analyze the effect of hysteroscopy combined with uterine artery embolization （UAE）in treating cesarean scar pregnancy （CSP）.METHODS：A total of 20 patients with ce-sarean scar pregnancy and admitted to our hospital from 201 1 to 2013 were enrolled in the study.UAE and methotrexate were in-jected into artery before treatment.When the value of serum β-HCG dropped to 1000 U/L and the layer of serosa in lesion was thicker than 0.2 cm in ultrasonography,laparoscopic surgical ex-cision of the lesion was conducted.RESULTS：The hysteroscopy of all patients lasted for 20~41 min with the average duration of 22.3 ±3.5 min.Intranperative blood loss was 18.25 ±5.73 mL. No conversion into open surgery and no complication occurred. The serum β-HCG dropped to 113.7 ±35.2 U/L after the surger-y,and menstruation became normal 40.2 ±2.5 d postoperatively. CONCLUSION：Treating cesarean scar pregnancy （CSP）by hysteroscopy combined with uterine artery embolization （UAE ） can harvest satisfactory therapeutic effect,and it is effective trea-ting method.