子宫动脉介入栓塞在子宫瘢痕妊娠中的应用

Application of uterine artery embolization in patients with cesarean scar pregnancy

目的探讨子宫动脉介入栓塞术在剖宫产术后子宫瘢痕妊娠(CSP)中应用的效果及适应证。方法回顾性分析42例在我院进行治疗的CSP患者,其中21例采用子宫动脉介入栓塞并灌注甲氨蝶呤(MTX)后清宫(实验组),另21例采用MTX肌肉注射杀胚后清宫(对照组),比较两组临床效果。结果实验组清宫术中出血量明显少于对照组,住院天数及住院费用则明显多于对照组(P<0.05)。实验组有1例出现疼痛的不良反应。两组血HCG下降比例差异无统计学意义。结论子宫动脉介入栓塞能减少CSP患者清宫术中出血,但一定程度上增加了患者的经济负担,且存在疼痛等不良反应及相关并发症的风险。准确把握子宫动脉介入栓塞适应证,将更有利于CSP患者的治疗。

Objective To explore the application value and indication of uterine artery embolization in the patients with cesarean scar pregnancy （CSP）. Methods We retrospectively analyzed 42 patients with CSP,in which 21 patients received curettage after uterine artery embolization combined with MTX infusion （experimental group） while another 21 patients was treated with curettage after MTX injection （control group）. The outcomes were compared between the two groups. Results In the experimental group, the bleeding volume during curettage was less, but more in hospitalization time and hospitalized expense when compared to the control group. One patient experienced pain after uterine artery embolization. There was no significant difference in blood hCG drop between the two groups. Conclusion Uterine artery embolization brings pain and relatively high financial burden to CSP patients but less blood loss. So, the accurate indications of this method are needed to make sure CSP patients benefit more from it.