中国工程科学Issue(5)：4-10,7.
子宫动脉灌注栓塞联合清宫术治疗子宫剖宫产瘢痕妊娠的效果评价
Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy
冯颖 1李坚 1陈素文 1李长东 1张晓峰 1胡乔飞1
作者信息
- 1. 首都医科大学附属北京妇产医院计划生育科，北京100006
- 折叠
摘要
Abstract
To evaluate the effect of curettage after uterine artery embolization and methotrex-ate(UACE)treatment for caesarean scar pregnancy(CSP). A retrospective study on 140 pa-tients diagnosed with CSP between February 2003 to April 2013 at Beijing Obstetrics and Gyn-aecology Hospital was carried out. 35 patients between February 2003 to March 2010 were of-fered systemic chemotherapy and local injection with methotrexate(MTX)prior to uterine suc-tion curettage. 105 patients between April 2010 to April 2013 were offered prophylactic UACE prior to uterine suction curettage with using ultrasound/hysteroscopy/laparoscopy-guided uter-ine curettage. The operation time,blood loss,uterine retention rate,hospitalization days serum beta-HCG,menstrual recover,serious adverse effect and medical expense of two groups were re-corded and compared. The results show that among 140 cases of CSP,108 cases were diag-nosed in our hospital by transabdominal ultrasound and transvaginal ultrasound exactly. 3 cases were misdiagnosed in our hospital. 32 cases were referred from other hospitals where the initial management with uterine suction curettage had resulted in uncontrollable massive haemorrhage. In MTX group,33 patients with CSP recovered without complications and 2 patients underwent emergency hysterectomy for massive haemorrhage. In UACE group,100 patients were treated successfully with UACE. Three patients were received second UACE as uncontrolled massive vaginal hemorrhage. No significant difference in preoperative indicators was found between two groups including average age,menopause time,gestational sac diameter and β-HCG levels. But after the operation,we found significant difference between MTX group and UACE group in uterine retention rates. The significant differences were also observed in the amount of vagi-nal bleeding during uterine suction curettage:average hospitalization days,average resume time inβ-HCG levels and medical expense between MTX group and UACE group. No treatment-related complications occurred in long-term observation in neither of the groups. Based observ-ing our patients,it appears that ultrasound-guided curettage after uterine artery embolization combined with methotrexate may be an effective means of treatment for caesarean scar pregnan-cy.关键词
剖宫产瘢痕妊娠/子宫动脉栓塞术/甲氨蝶呤/清宫术Key words
CSP/UACE/MTX/suction curettage分类
医药卫生引用本文复制引用
冯颖,李坚,陈素文,李长东,张晓峰,胡乔飞..子宫动脉灌注栓塞联合清宫术治疗子宫剖宫产瘢痕妊娠的效果评价[J].中国工程科学,2014,(5):4-10,7.
