剖宫产切口瘢痕妊娠26例的影像学特点与治疗分析

The imaging characteristics of cesarean scar pregnancy in 26 cases and their interventional therapy

目的探讨剖宫产切口瘢痕妊娠（CSP）的影像学特点并分析子宫动脉化疗栓塞术（UACE）治疗的临床效果。方法回顾性分析2010-01～2014-10该院收治的26例CSP患者的临床资料,先分析CSP影像特点及对临床指导意义,再经双侧子宫动脉各灌注甲氨蝶呤（methotrexate,MTX）50 mg、庆大霉素8万U,再以明胶海绵栓塞,术后24～72 h时行清宫术。结果 CSP影像特点能为UACE术后个体化治疗方案提供准确依据,UACE操作成功率为100%,清宫术中出血量为50～150 ml,无严重并发症发生。结论 UACE配合清宫术能明显降低子宫切除和丧失生育能力的风险,为CSP患者最佳治疗的选择。

Objective To investigate the imaging characteristics of cesarean scar pregnancy （CSP） and the clinical effect of uterine artery ehemoembolization（UACE） on CSP. Methods We retrospectively analyzed tile clini- cal data of 26 patients with CSP who were admitted to our hospital from January 2010 to October 2014. The imaging characteristics of CSP and its clinical significance were analyzed. Uterine artery super selective intubation was carried out in all patients with a local perfusion of methotrexate（MTX） 50 mg and Gentamycin 80 000 units. After the injec- tion, the embolization of uterine artery was achieved with the gelatin sponge. Uterus curettage was performed in all patients within 24 to 72 hours after tile embolization. Results The imaging characteristics of CSP can provide basis for postoperational individualized treatment. The successful rate of UACE was 100%. The bleeding volume in uterus curettage was between 50 and 150 ml. No serious complications were found. Conclusion UACE combine with uterus curettage can significantly reduce the risk of uterectomv and infertile.