子宫动脉化疗栓塞联合清宫术治疗子宫瘢痕妊娠的临床分析

Clinical analysis of uterine artery chemotherapy embolization via in treatment of cesarean scar pregnancy

目的探讨子宫动脉化疗栓塞(UACE)联合清宫术对剖宫产后子宫瘢痕妊娠(CSP)的治疗价值。方法回顾性分析2008年1月至年3月我院收治的78例CSP患者的临床资料。2008年1月至2010年9月,我科对30例CSP患者采用甲氨蝶呤注射联合清宫术治疗(MTX组);2010年10月至年3月对48例CSP患者采用子宫动脉甲氨蝶呤灌注+子宫动脉栓塞联合清宫术治疗(UACE组)。比较两组的术中出血量、血清人绒毛膜促性腺激素(HCG)转阴时间和住院时间,并比较两组患者的不良反应发生率。结果 UACE组的术中出血量、HCG转阴时间、住院时间均少于MTX组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 UACE联合清宫术治疗CSP安全可靠,疗效满意。

Objective To observe the clinical effect of uterine artery chemotherapy embolization （UACE） combined with suction cu- rettage on the treatment of cesarean scar pregnancy （CSP）. Methods A total of 78 patients diagnosed with CSP in our department between January 2008 and March were retrospectively studied. Of the patients, 30 between January 2008 and September 2010 were treated with methotrexate （MTX） by intramuscular injection and uterine suction curettage, and 48 between October 2010 and March with UACE prior to uterine suction curettage. Hemorrhage volume, time for serum β-HCG recovery to normal, hospitalization days and adverse effect were recorded and compared between the two groups. Results The hemorrhage volume, β-HCG recovery time and hos- pitalization days in UACE group were significantly less than that in MTX group （P 〈 0.05）. There was no significant difference in ad- verse effect between the two groups （P 〉 0.05）. Conclusion UACE combined with suction curettage in treatment of CSP is safe, re- liable and effective.