子宫动脉栓塞后清宫治疗内生型剖宫产瘢痕妊娠的临床分析

    Clinical analysis of the curettage in the treatment of endogenic cesarean scar pregnancy after uterine artery embolization

    • 摘要: 目的:探讨子宫动脉栓塞联合清宫术治疗内生型剖宫产术后瘢痕妊娠(CSP)的临床疗效和安全性。方法:内生型CSP病人70例,行子宫动脉栓塞后72 h内,B超监护下行清宫术,观察病人CSP终止妊娠率、术中出血量、术后有无再出血、宫内残留情况、人绒毛膜促性腺激素恢复正常时间、月经恢复时间和术后并发症发生情况。结果:70例病人均成功行子宫动脉栓塞后清宫治疗,清宫治疗终止妊娠率为98.57%(69/70)。清宫术中出血量为(23.33±47.22) mL,人绒毛膜促性腺激素恢复正常时间为(20.73±5.53) d,术后月经恢复平均时间为(40.97±8.97) d,术后1周复查彩超均无宫内残留,所有病人均无治疗性并发症发生。结论:子宫动脉栓塞联合清宫术治疗内生型CSP具有成功率高、出血少、并发症少的特点,是一种安全有效的治疗方法,值得临床推广。

       

      Abstract: Objective:To discuss the clinical effectiveness and safety of the curettage combined with uterine artery embolization in the treatment of endogenic cesarean scar pregnancy(CSP).Methods:Seventy patients with endogenic CSP were treated with uterine curettage guided by color Doppler ultrasound after 72h of uterine artery embolization.The successful rate of abortion,peroperative bleeding,postoperative bleeding,intrauterine residue,time of β-hCG andmenstruation returning to normal,and complication in all patients were observed.Results:All operations in 70 cases were successfully,and the abortion rate was 98.57%(69/70).The mean bleeding during operation was(23.33+47.22)mL.The time of β-hCG and menstruation returning to normal were(20.73±5.53) and(40.97±8.97) days after operation,respectively.There was no intrauterine residue under abdominal color Doppler ultrasound after 1 week of curettage.There was no complication among all patients.Conclusions:The curettage combined with uterine artery embolization in the treatment of CSP has high success rate,less bleeding,fewer complications,is safe and effective,which is worthy of clinical promotion.

       

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