子宫动脉栓塞术对剖宫产术后瘢痕部位妊娠的治疗价值

目的：随着剖宫产率的不断攀升，剖宫产术后瘢痕部位妊娠的发生率已日趋增多。本研究将探讨子宫动脉栓塞术对剖宫产术后瘢痕部位妊娠的治疗价值。方法：选择我院2009年03月至2013年03月剖宫产术后瘢痕部位妊娠的患者共28例，均行双侧子宫动脉栓塞治疗，收集其主要临床资料，包括术中出血量、血HCG下降情况、住院时间、住院费用、月经复潮时间及不良反应，并进行回顾性分析。结果：28例患者均治疗有效，24例患者栓塞治疗后行清宫术，术中出血量5-200（平均36．5±4．8）mL，另4例栓塞治疗后未行清宫术。平均住院时间为13．6±4．7天。28例血β-HCG于栓塞后7～38天降为正常，超声检查示子宫复旧的平均时间为20—36天，栓塞后28-44天月经复潮。结论：28例患者采用UAE联合MTX灌注化疗治疗后出血量少，恢复快，疗效显著。子宫动脉栓塞术能有效防止和控制出血，保留妇女生育功能，是一种安全、有效的治疗方法。

Therapeutic Value of Uterine Artery Embolization for Cesarean Scar Pregnancy

Objective： With the rising rate of cesarean section, the incidence of cesarean scar pregnancy is increasing. Our aim is to explore the therapeutic value of uterine artery embolization （UAE） for cesarean scar pregnancy （CSP）. Methods： 28 cases of CSP treated by UAE were retrospectively enrolled in this study from Mar 2009 to Mar 2013 in the hospital. They were undertaken uterine artery embolization and their main clinical data were collected, including blood loss, decline in serum HCG, length of stay, hospital costs, menstruation time and adverse reactions. The above all were analyzed retrospectively. Results： UAE was effective in 28 patients. 24 patients had curettage and suction after UAE. Blood loss was 5 to 200 （mean 36.5：1： 4.8） mL, and the other four cases did not have curet- tage after embolization. The average length of hospital stay was 13.6 ± 4.7 days. Serum β-HCG level in 28 cases decreased to normal 7 to 38 days after embolization. Ultrasound examination revealed that uterine involution had an average of 20-36 days. Menstruation recovered after 28 to 44 days. Conclusion： After treating with UAE plus MTX infusion chemotherapy, 28 cases had less bleeding, faster recovery and a significant effect. Uterine artery embolization can effectively prevent and control bleeding, reserve women＇s reproductive function, which is a safe and effective treatment.