剖宫产疤痕妊娠的诊断及介入治疗的研究进展

Recent advances in the study ofthe diagnosis of cesarean scar pregnancy and the use of uterine artery embolization

剖宫产疤痕妊娠(cesarean scar pregnancy,CSP)是1978年由Larson及Solomon首次报道的。近年来随着剖宫产率的增加及我国"二孩"政策的开放,剖宫产疤痕妊娠在我国的发生率呈明显上升趋势[1]。目前,由于该病临床表现的多样性,迄今为止尚未就诊疗规范形成共识。子宫动脉栓塞术(uterine artery embolization,UAE)于1979年首次被运用于产后出血,2002年Ghezzi等[2]首次将UAE用于剖宫产疤痕妊娠的治疗,取得良好的效果。目前,该方法被普遍应用于辅助CSP的治疗,可作为清宫术或手术前处理,以防大出血或止血。但子宫动脉栓塞术治疗CSP的适应症目前并无统一标准,因此,本文就CSP的诊断及介入治疗进行综述。

Cesarean scar pregnancy（ CSP） was first recorded by Larson and Solomon in 1978. Because of the increased rate of cesarean sections and two-child policy performed in China,the incidence of cesarean scar pregnancy has been gradually increasing. At present,CSP was so complicated that there was no consensus on the management of CSP. Uterine artery embolization was first used to cure postpartum hemorrhage in 1979,and to manage CSP by Ghezzi in 2002. In fact,its effect was very good. And now it is used to help manage CSP before surgery in case of hemorrhage or deal with hemorrhage. As it is known,there is no criterion to guide its usage. Thus,this paper is to make a presentation about the diagnosis of CSP as well as the use of uterine artery embolization（ UAE）in CSP.