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目的:观察子宫动脉化疗栓塞术(UACE)治疗剖宫产术后子宫瘢痕的临床效果。方法:将96例患者随机会为观察组和对照组各48例,对照组采用甲氨蝶呤(MTX)全身用药+刮宫,观察组采用UACE治疗。结果:观察组48例患者行UACE全部成功,对于16例大出血患者,15均一次性止血成功,1另因合并子宫肌瘤要求行子宫全切除。对照组48例中,26例治愈后再次成功妊娠,13例在术中因大出血加用缩宫剂或局部压迫后改行注射甲氨蝶呤(MTA)获得成功。9例行急诊子宫切除术。并定期复查血血人绒毛膜促性腺激素(HCG),观察组清宫时间为(11.3±5.8)天,对照组为(32.7±8.9)天,P<0.05。结论:UACE治疗方法在诊断治疗方面安全有效,值得临床运用和推广。
Objective: To observe the clinical effect of uterine arterial chemoembolization (UACE) in treating uterine scar after cesarean section. Methods: Ninety-six patients were randomly divided into observation group and control group, 48 cases in each group. The control group was treated with methotrexate (MTX) and curettage. The observation group was treated with UACE. Results: 48 patients in the observation group were all successful in UACE. Of the 16 patients with massive hemorrhage, 15 had a one-time hemostatic success, and 1 required total hysterectomy due to uterine fibroids. In the control group of 48 cases, 26 cases were cured again after successful pregnancy, 13 cases of intraoperative blood loss plus uterine contraction or local compression after the conversion of methotrexate (MTA) was successful. Nine patients underwent emergency hysterectomy. Blood and human chorionic gonadotropin (HCG) were regularly reexamined. The observation group had a clear time of (11.3 ± 5.8) days and a control group of (32.7 ± 8.9) days, P <0.05. Conclusion: UACE treatment is safe and effective in diagnosis and treatment, which is worthy of clinical application and promotion.