子宫动脉栓塞术对子宫颈妊娠患者再生育结局的影响

Effect of uterine artery embolization on reproductive outcomes of patients with cervical pregnancy

目的 探讨子宫动脉栓塞术(uterine artery embolization,UAE)对子宫颈妊娠患者再生育结局的影响。方法回顾性分析中国医科大学附属盛京医院2014年1月至2019年12月确诊的子宫颈妊娠患者的临床资料,根据纳入及排除标准选择其中有再生育需求的患者共49例,分为UAE组(19例)及非UAE组(30例),比较两组患者的基本情况以及再次妊娠结局。结果 UAE组患者的血清β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-h CG)中位数(14764.0 U/L)高于非UAE组(6271.5 U/L),差异有统计学意义(P<0.05)。两组患者的年龄、体重指数、吸烟史、停经时间、孕产次、有无胎心、包块大小等差异均无统计学意义(均P>0.05)。UAE组与非UAE组的平均随访时间分别为(45.32±16.20)个月和(38.30±16.88)个月,至随访结束,UAE组患者的术后妊娠率和活产率分别为36.8%和85.7%,非UAE组患者分别为60.0%和55.6%,UAE组患者的妊娠率低于非UAE组,活产率高于非UAE组,但差异均无统计学意义(均P>0.05)。结论 UAE对子宫颈妊娠患者是一种安全的辅助治疗措施,对其术后再次妊娠的妊娠率及活产率均无明显影响。

Objective To investigate the effect of uterine artery embolization(UAE)on the outcomes of reproduction in patients with cervical pregnancy(CP).Methods A retrospective analysis was performed on cases of CP treated from January 2014 to December 2019 in Shengjing Hospital of China Medical University. According to the inclusion and exclusion criteria,a total of 49 patients with reproductive needs were selected and divided into a UAE group(n=19)and a non-UAE group(n=30).Compare the basic information and outcome of reproduction between the two groups.Results The median value of serum β-h CG in the UAE group(14764.0 U/L)was higher than that of the non-UAE group(6271.5 U/L),and the difference was statistically significant. There was no significant difference in age,body mass index,smoking history,gestational age,times of pregnancy and labor,fetal heart activity or mass size between the two groups. The average follow-up time of the UAE group and the non-UAE group was 45 and 38 months,respectively. At the end of the follow-up,the postoperative pregnancy rate of the UAE group was 36.8%,and the live birth rate was85.7%,while in the non-UAE group they were 60.0% and 55.6%,respectively. The pregnancy rate of the UAE group was lower than that of the non-UAE group,and the live birth rate was higher than that of the non-UAE group,but the differences were not statistically significant.Conclusion UAE is a safe adjunctive treatment for patients with CP,and has no significant effect on the pregnancy rate and live birth rate of subsequent pregnancy.