双侧子宫动脉栓塞术后清宫治疗子宫瘢痕妊娠对卵巢功能的影响

The influence of uterine artery embolization on ovarian ruction for the treatment of uterine scar pregnancy

目的 探讨使用子宫动脉栓塞术（UAE）治疗剖宫产瘢痕妊娠对卵巢功能的影响。方法 选择2012年6月-2015年6月我院住院治疗的46例剖宫产切口瘢痕妊娠患者,其中24例行UAE后B超引导下行清宫术,22例行腹腔镜下病灶切除术进行治疗。比较两组患者的一般资料及术后患者月经复潮情况,分别于术前、术后月经恢复正常后的第3个月和6个月月经来潮的第2天检查行卵巢激素检测,包括孕激素（P）、促卵泡激素（FSH）、促黄体生成激素（LH）、雌二醇（E2）及泌乳素（PRL）,对两组检测结果分别进行统计学分析比较,同时观察是否出现卵巢早衰或绝经期症状,如闭经,潮热,烦躁等。结果 两组患者一般情况比较,差异无统计学意义（P〉0.05）;与腹腔镜组比较,UAE组患者术后月经复潮时间较长,差异有统计学意义（P〈0.05）;术前两组各卵巢内分泌功能指标比较,差异无统计学意义（P〉0.05）;术后的3、6个月,两组卵巢的内分泌功能测试指标比较,差异无统计学意义（P〉0.05）;观察期内均未出现卵巢早衰及围绝经期症状。结论 UAE治疗子宫瘢痕妊娠对卵巢的内分泌功能无明显影响。

To explore the influence of uterine artery embolization（UAE）on ovarian ruction for the treatment of uterine scar pregnancy.Methods Choose 46 patients diagnosed as cesarean scar pregnancy and treated in our hospital from June 2012 to June 2015.24 of them received ultrasound-guided curettage after uterine artery embolization,and the other 22 patients were treated by laparoscopic.To compared the general information of two groups,and the time to return to normal menstrual cycle.For all of these patients,serum levels of concentrations of progestogen （P）,follicule Stimulating hormone（FSH）,luteotropic hormone（LH）,estrin（E2）,and prolactin（PRL） were measured before operation and the second day when the menstruation came back 3,6 months after the operation.The data of two groups were statistically analyzed and compared.At the same time,we observed whether premature ovarian failure or menopausal symptoms appeared,such as amenorrhea,hot flashes,irritability etc.Results There was no statistical significance between the two groups in general information.Compared with laparoscopic group,patients in UAE group needed a long time to return to normal menstrual cycle,and there was statistically significant （P〈0.05）.There was no statistical significance between the two groups in ovarian endocrine function before the operation （P〉0.05）.There was no statistical significance between the two groups in ovarian endocrine function after 3 months and 6 months postoperatively （P〉0.05）.No premature ovarian failure and perimenopausal symptoms was observed during the observation period.Conclusion There is no effect on ovarian endocrine function of uterine artery embolization （UAE） for treatment uterine scar pregnancy.