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目的探讨双侧子宫动脉化疗栓塞术治疗剖宫产子宫切口妊娠的临床应用价值。方法 2004年3月2009年10月确诊剖宫产子宫切口妊娠的患者25例。首先行双侧子宫动脉超选择插管,注入甲氨喋岭,再用明胶海绵条栓塞双侧子宫动脉,48～72h内在B型超声监测下行清宫术。结果 25例子宫动脉化疗栓塞术后复查B型超声,提示孕囊血供明显减少。22例在B型超声监测下一次性清除胚胎组织,出血量少;2例因胚胎植入肌层突向浆膜层栓塞术后加用氟尿嘧啶,未行清宫,自行排出;1例因术后切口处形成大血肿行手术治疗。结论双侧子宫动脉化疗栓塞术是治疗剖宫产子宫切口妊娠一种有效方法,既保留子宫,又保留其生育功能。
Objective To investigate the clinical value of bilateral uterine arterial chemoembolization in the treatment of cesarean section uterine incision pregnancy. Methods Twenty - five patients with confirmed cesarean section uterine incision pregnancy were diagnosed in March 2004 and October 2009. First of all, bilateral uterine artery superselective catheterization, injection of methotrexate Ridge, and then gelatin sponge embolization of bilateral uterine artery, 48 ~ 72h within the B-mode ultrasound monitoring of curettage. Results 25 cases of uterine artery chemoembolization after the review of B-mode ultrasound, suggesting that gestational sac blood supply was significantly reduced. Twenty-two cases had a one-time eradication of embryo tissue under B-mode ultrasonography, with a small amount of bleeding. Two cases were treated with fluorouracil after embolization of the muscular layer to the serosal layer, Incision at the formation of large hematoma surgical treatment. Conclusion Bilateral uterine arterial chemoembolization is an effective method for cesarean section uterine incision pregnancy, which not only retains the uterus, but also retains its reproductive function.