早期瘢痕妊娠子宫动脉栓塞15例临床分析

Clinical analysis of 15 cases of early scar pregnancy uterine artery embolization

目的:探讨子宫动脉栓塞在子宫瘢痕妊娠治疗中的临床价值。方法:2011年1月-2013年12月收治剖宫产瘢痕妊娠患者15例,回顾性分析其诊治过程。其中3例外院误诊早孕行人工流产术中出血多填塞后转诊至我院,另12例初诊即确诊早期瘢痕妊娠,3例入院即急诊行子宫动脉介入栓塞,12例择期子宫动脉介入栓塞,15例均在术后48~72 h内在B超引导下行负压吸宫术。结果:3例急诊子宫动脉介入栓塞后子宫无活动性出血,15例均在B超引导下行负压吸宫术,吸宫过程顺利,无活动性出血,组织均可见绒毛,术后病理提示退变坏死绒毛,术后阴道流血3~7 d,术后40 d左右恢复月经。结论:子宫动脉介入栓塞结合B超引导下负压吸宫术,对早期子宫瘢痕妊娠疗效确切,出血量少,创伤小,住院时间短。

Objective:To explore the clinical value of uterine artery embolization in the treatment of cesarean scar pregnancy.Methods:15 cases with cesarean scars pregnancy were selected from January 2011 to December 2013.Their diagnosis and treatment process were retrospectively analyzed.3 cases were misdiagnosed pregnancy and given artificial abortion.They had more intraoperative bleeding and referred to our hospital.Another 12 cases were diagnosed early scar pregnancy in the first visit.3 cases were given uterine artery interventional embolization in emergency.12 cases were given uterine artery interventional embolization in selecting a good time.15 cases were given negative pressure uterine aspiration under B ultrasound guidance in postoperative48~72 hours.Results:3 cases had no active uterine bleeding after emergency uterine artery interventional embolization.15 cases were given negative pressure uterine aspiration under B ultrasound guidance.The palace absorption process was smooth without active bleeding.The organizations were visible fluff.The postoperative pathological results showed degeneration necrosis of fluff.The postoperative vaginal bleeding were about 3 to 7 days.The menstruation was recovery about 40 days after operation.Conclusion:Uterine artery interventional embolization combined with negative pressure uterine aspiration under B ultrasound guidance has exact efficacy for early uterine scar pregnancy.It has less bleeding,less trauma and shorter hospitalization time.