子宫动脉栓塞术联合动脉灌注化疗治疗剖宫产术后子宫瘢痕妊娠的效果

Effect of uterine arterialembolism combined with artery infusion chemotherapy in treating cesarean scar pregnancy after cesarean delivery

目的探讨子宫动脉栓塞术联合动脉灌注化疗在剖宫产术后子宫瘢痕妊娠治疗中的价值。方法选取2009年9月~2014年9月我院收治的70例子宫瘢痕妊娠患者,将其随机分为对照组和治疗组,对照组35例给予米非司酮联合甲氨蝶呤治疗,酌情行清宫术。治疗组35例给予子宫动脉栓塞术联合动脉灌注甲氨蝶呤治疗,术后行清宫术。对比两组临床疗效。结果治疗组患者出血量为（125.6±25.6）ml,β-HCG恢复至正常的时间为（20.7±4.9）d,住院时间为（9.7±2.4）d,月经恢复正常时间为（42.1±5.6）d。对照组患者出血量为（675±26.8）ml,β-HCG恢复至正常的时间为（39.5±4.4）d,住院时间为（23.4±4.2）d,月经恢复正常时间为（62.5±9.5）d。两组比较差异有统计学意义（P〈0.05）。对照组术后有3例出现低热症状,治疗组有2例出现低热症状,两组患者并发症发生情况比较,差异无统计学意义（P〉0.05）。结论子宫动脉栓塞术联合动脉灌注化疗治疗剖宫产术后子宫瘢痕妊娠安全、可靠,效果确切,值得临床推广。

Objective To explore the value of uterine arterialembolism combined with artery infusion chemotherapy in treating cesarean scar pregnancy after cesarean delivery. Methods 70 cesarean scar pregnancy patients from September2009 to September 2014 of our hospital were selected.Patients were randomly divided into control group and treatment group.35 patients in control group were given mifepristone combined with methotrexate,and curettage was taken discretionary.35 patients in treatment group were given uterine arterialembolism combined with artery infusion chemotherapy and curettage was taken after operation.The clinical effect between two groups was compared. Results The amount of bleeding in treatment group was（125.6±25.6）ml,the time of β-HCG to recover was（20.7±4.9） d,hospital time was（9.7±2.4） d,the time of menstruation back to normal was（42.1±5.6） d.The amount of bleeding in control group was（675±26.8）ml,the time of β-HCG to recover was（39.5±4.4） d,hospital time was（23.4±4.2）d,the time of menstruation back to normal was（62.5±9.5） d.The difference between two group was obvious,and the difference was statistical significance（P0.05）.3 cases had low-grade fever in control group and 2 cases in treatment group.The incidence situation of complications between two groups had no significantly difference（P0.05）. Conclusion It is safe,reliable and exact effect that uterine arterialembolism combined with artery infusion chemotherapy in treating cesarean scar pregnancy after cesarean delivery.It is worth to popularize in clinical.