子宫动脉栓塞与化疗栓塞治疗瘢痕妊娠疗效比较

发布时间：2019-01-14 09:50

【摘要】：目的评价子宫动脉灌注化疗栓塞术(UACE)和子宫动脉栓塞术(UAE)后清宫治疗剖宫产瘢痕妊娠(CSP)的疗效。方法经临床确诊CSP患者79例,根据不同介入方法随机分为两组,UACE组(A组)43例,UAE组(B组)36例,每组再根据CSP类型分为内生型和外生型2个亚组,介入治疗后行清宫术。以清宫术中出血量、人绒毛膜促性腺激素(HCG)恢复正常时间、二次治疗率、治疗成功率作为疗效评估参数,比较两组间、亚组间相关数据的差异。结果两组介入治疗后清宫手术均顺利,无子宫切除。两组HCG恢复正常时间、并发症发生情况、二次治疗率比较差异有统计学意义(P0.05)。A组内生型28例,B组25例,治疗成功率分别为100%(28/28)和96.0%(24/25)(P0.05);A组外生型15例,B组11例,治疗成功率分别为86.7%(13/15)和45.5%(5/11)(P0.05)。两组外生型患者术后阴道持续出血时间、月经复潮时间、HCG恢复正常时间、二次治疗率及治疗成功率差异均有统计学意义(P0.05)。结论UAE或UACE后清宫均为治疗CSP的安全有效方法。内生型CSP可考虑UAE,外生型CSP宜采用UACE。
[Abstract]:Objective to evaluate the efficacy of uterine artery infusion chemoembolization (UACE) and uterine artery embolization (UAE) in the treatment of cesarean scar pregnancy with (CSP). Methods Seventy-nine patients with CSP were randomly divided into two groups according to different interventional methods: UACE group (group A, 43 cases) and UAE group (group B, 36 cases). Each group was further divided into two subgroups according to CSP type: endogenous type and exogenous type. After interventional therapy, the uterus was cleared. The blood loss, the time of recovery of human chorionic gonadotropin (HCG), the rate of secondary treatment and the success rate of treatment were used as parameters to evaluate the curative effect. Results after interventional therapy, the operation was smooth and no hysterectomy was found. There were significant differences in the recovery time of HCG, the occurrence of complications and the rate of secondary treatment between the two groups (P0.05). There were 28 cases of endogenous type in). A group, 25 cases in group B, and 2 cases in group B, respectively. The success rate was 100% (28 / 28) and 96.0% (24 / 25) respectively (P0.05). The success rate of treatment was 86.7% (13 / 15) in group A and 45.5% (5 / 11) in group B (P0.05). There were significant differences between the two groups in the time of continuous vaginal bleeding, menorrhagia time, HCG recovery time, the rate of secondary treatment and the success rate of treatment (P0.05). Conclusion clearing the uterus after UAE or UACE is a safe and effective method for the treatment of CSP. Endogenous CSP can consider UAE, exogenous CSP should adopt UACE.
【作者单位】：南方医科大学附属深圳市妇幼保健院放射科;南方医科大学附属深圳市妇幼保健院妇科;
【分类号】：R714.22

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