经阴道彩色多普勒超声评价子宫动脉栓塞术对子宫瘢痕妊娠的治疗效果

Evaluation of the curative effect of uterine artery embolization in the treatment of uterine scar pregnancy by transvaginal color doppler ultrasound

目的:探讨经阴道彩色多普勒超声评价子宫动脉栓塞术对子宫瘢痕妊娠的治疗效果。方法:2013年1月-2014年10月收治采用子宫动脉栓塞术治疗的子宫瘢痕妊娠患者50例,所有患者均有剖宫产史,均采用彩色多普勒进行检查,经腹部及阴道检查子宫及双侧附件区域情况,观察病灶着床情况。均确诊为子宫瘢痕妊娠,并于1周内行子宫动脉栓塞术治疗。结果:彩色多普勒超声表现为患者子宫正常或稍大,孕囊多位于子宫峡部切口处,脉冲多普勒显示高速低阻动脉血流信号,彩色多普勒血流显像可见孕囊周边丰富的环状血流信号,子宫前壁靠近切口处血流信号增多。血管造影表现:50例患者均成功栓塞,栓塞侧子宫动脉增粗,宫颈体积增大,可见胚胎血供丰富。子宫动脉栓塞治疗后彩色多普勒变化:治疗后妊娠囊缩小38例,孕囊无变化12例。结论:子宫动脉栓塞术治疗子宫瘢痕妊娠创伤小、出血少、疗效显著,经阴道彩色多普勒超声检查可以清晰地看到子宫形态、动脉血流及孕囊变化,值得临床推广。

Objective:To explore the curative effect of uterine artery embolization in the treatment of uterine scar pregnancy by transvaginal color doppler ultrasound.Methods:50 patients with uterine scar pregnancy treated by uterine artery embolization were selected from January 2013 to October 2014.All of the patients had the history of cesarean section,and they were examined by col-or doppler,transabdominal and transvaginal examination of uterus and bilateral accessory area,lesions implantation situation was observed.All patients were diagnosed as uterine scar pregnancy,and adept uterine artery embolization for treatment within a week. Results:The color doppler showed that the patients'' uterine were normal or slightly larger,the gestational sac located in the isth-mus of uterine incision.Pulse doppler showed high speed low resistance arterial blood flow signal,color doppler flow imaging showed rich annular flow signal surrounding the pregnant sac,the blood flow signal increased near the incision of anterior uterine wall.Angiographic manifestations:50 cases were successful embolized,uterine artery embolization side was enlargement,cervical volume increased,the embryo blood supply was rich.Color doppler changes after uterine artery embolization:gestational sac re-duced in 38 cases after the treatment,12 cases of gestational sac were not change.Conclusion:Uterine artery embolization for treat-ment of uterine scar pregnancy with small trauma,less bleeding,the curative effect is remarkable,transvaginal color doppler ultra-sonography can clearly see the shape of uterus,artery blood flow and the change of gestational sac,deserve the clinical expansion.