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目的探讨子宫动脉化疗栓塞在剖宫产术后子宫切口妊娠治疗中的可行性和安全性。方法回顾分析2006年7月-2011年3月收治的152例剖宫产切口瘢痕妊娠行介入治疗的病例资料。结果 152例子宫动脉化疗栓塞操作均成功。阴道大出血或不规则出血均得到有效控制。人绒毛膜促性腺激素β亚型较术前下降,差异有统计学意义(Z=9.295,P=0.000),术后2～22 d行清宫术,术中失血3～100 mL,平均27 mL。3例行子宫切除术,子宫切除率2%。1例发生栓子脱落导致左下肢胫前动脉栓塞并发症。结论子宫动脉化疗栓塞治疗剖宫产术后切口妊娠可有效控制大出血、降低清宫风险、降低子宫切除风险,是治疗切口妊娠的有效可行方法之一。
Objective To investigate the feasibility and safety of uterine artery chemoembolization in the treatment of uterine incision pregnancy after cesarean section. Methods A retrospective analysis of 152 cases of cesarean scar incision in July 2006-March 2011 were performed in the interventional treatment of case data. Results 152 cases of uterine artery chemoembolization operation were successful. Vaginal bleeding or irregular bleeding have been effectively controlled. The β subtype of human chorionic gonadotropin was significantly lower than that before operation (Z = 9.295, P = 0.000). The curettage was performed between 2 and 22 days after operation. The intraoperative blood loss was 3 to 100 mL with an average of 27 mL . 3 routine hysterectomy, hysterectomy rate of 2%. A case of emboli loss led to complications of anterior tibial artery embolization of the left lower extremity. Conclusion Uterine arterial chemoembolization for cesarean section after incision pregnancy can effectively control bleeding, reduce the risk of hysteroscopy and reduce the risk of hysterectomy, is an effective and feasible method for the treatment of incisional pregnancy.