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目的:评估双侧子宫动脉化疗栓塞术治疗剖宫产术后瘢痕妊娠(CSP)的临床应用价值。方法:回顾性分析23例CSP患者双侧子宫动脉化疗栓塞前后的临床资料。结果:23例患者中,10例患者因瘢痕妊娠清宫术发生阴道出血而采用急诊子宫动脉化疗栓塞介入治疗;余13例患者采用子宫动脉化疗栓塞序贯超声引导下清宫术治疗。所有发生阴道出血患者于介入术后均停止出血;且介入术后序贯清宫术治疗的患者于清宫术中均未出现大出血并发症。1月后复查,所有患者β-HCG均完全降至正常。结论:UACE术可用于CSP患者清宫术中大出血的紧急治疗;而UACE术序贯超声引导下清宫术治疗可能是一种更为安全有效地治疗CSP的新策略。
Objective: To evaluate the clinical value of bilateral uterine arterial chemoembolization in the treatment of scar pregnancy (CSP) after cesarean section. Methods: The clinical data of 23 patients with CSP before and after bilateral uterine artery chemoembolization were retrospectively analyzed. Results: Of the 23 patients, 10 cases received vaginal bleeding due to scarring during pregnancy and uterine artery embolization with emergency uterine artery embolization. Thirteen patients were treated with uterine arterial embolization and sequential uterine ultrasound guided radical curettage. All patients with vaginal bleeding stopped bleeding after the interventional procedure. No major bleeding complications occurred in patients undergoing curettage after interventional surgery. After 1 month of review, all patients with β-HCG were completely reduced to normal. Conclusions: UACE can be used for emergency treatment of major bleeding in CSP patients undergoing uterine surgery. However, UAC under the guidance of ultrasound therapy may be a new strategy to treat CSP safely and effectively.