• 四川大學(xué)華西第二醫(yī)院婦產(chǎn)科(成都,610041);

目的  探討子宮動脈化療栓塞在剖宮產(chǎn)術(shù)后子宮切口妊娠治療中的可行性和安全性。 方法  回顧分析2006年7月-2011年3月收治的152例剖宮產(chǎn)切口瘢痕妊娠行介入治療的病例資料。 結(jié)果  152例子宮動脈化療栓塞操作均成功。陰道大出血或不規(guī)則出血均得到有效控制。人絨毛膜促性腺激素β亞型較術(shù)前下降,差異有統(tǒng)計學(xué)意義(Z=?9.295,P=0.000),術(shù)后2~22 d行清宮術(shù),術(shù)中失血3~100 mL,平均27 mL。3例行子宮切除術(shù),子宮切除率2%。1例發(fā)生栓子脫落導(dǎo)致左下肢脛前動脈栓塞并發(fā)癥。 結(jié)論  子宮動脈化療栓塞治療剖宮產(chǎn)術(shù)后切口妊娠可有效控制大出血、降低清宮風(fēng)險、降低子宮切除風(fēng)險,是治療切口妊娠的有效可行方法之一。

引用本文: 黃麗萍,梁叆琳,劉輝. 子宮動脈化療栓塞在切口妊娠治療中的研究. 華西醫(yī)學(xué), 2012, 27(3): 360-362. doi: 復(fù)制

版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《華西醫(yī)學(xué)》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1.  Moschos E, Sreenasasimhaiah S, Twicklcr DM. First-trimester diagnosis of cesarean scar ectopic pregnancy[J]. J Clini Ultras, 2008, 36(8): 504-511.
2.  Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnencies[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
3.  Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
4.  Arruda Mde S, de Camargo Júnior HS. Cesarean scar ectopic pregnancy: a case report[J]. Rev Bras Ginecol Obstet, 2008, 30(10): 518-523.
5.  楊小蕓, 劉興會. 剖宮產(chǎn)切口瘢痕妊娠臨床特點及治療進展[J]. 中國實用婦科與產(chǎn)科雜志, 2010, 26(8): 585.
6.  Larsen JV. Solomon MH. Pregn ancy in a uterine seasacculus-an unusual cause of postabortal haemorrhage[J]. S Afr Med J, 1978, 53(4): 142-143.
7.  Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication[J]. Hum Reprod Update, 2004, 10(6): 515-523.
8.  Chen HY, Chen SJ, Hsieh FJ. Observation of cesarean section scar by transvaginal ultrasonography[J]. Ultrasound Med Biol, 1990, 16(5): 443-447.
9.  焦光瓊, 凌梅立, 錢尚萍. 經(jīng)陰道彩色多普勒超聲在診斷剖宮產(chǎn)子宮疤痕妊娠中的價值[J]. 上海醫(yī)學(xué)影像, 2004, 13(1): 16-18.
10.  Vial Y, Petignat P, Holfeld P. Pregnancy in a cesaream scar[J]. Ultracound Obstet Gynecol, 2000, 16(6): 592-593.
11.  莊亞玲, 韋浪花, 王雯黃, 等. 應(yīng)用子宮動脈栓塞術(shù)治療剖宮產(chǎn)瘢痕處妊娠[J]. 2008, 88(33): 2372-2374.
12.  Godin PA, Bassil S, Donnez XJ. An ectopic pregnancy developing in a previous caesarian section scar[J]. Fertil Steri, l997, 67(2): 398-400.
13.  張燕科, 吳瑞瑾, 林俊. 剖宮產(chǎn)術(shù)后子宮瘢痕處妊娠的早期診斷與治療[J]. 實用婦產(chǎn)科雜志, 2009, 25(12): 750-752.
14.  Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy[J]. Fertil Steril, 2010, 93(6): 1735-1740.
15.  Sugawara J, Senoo M, Chisaka H, et al. Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization[J]. Tohoku J Exp Med, 2005, 206(3): 261-265.
16.  Zhuang Y, Huang L. Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar[J]. Am J Obstet Gynecol, 2009, 201(2): 152. e1-3.
  1. 1.  Moschos E, Sreenasasimhaiah S, Twicklcr DM. First-trimester diagnosis of cesarean scar ectopic pregnancy[J]. J Clini Ultras, 2008, 36(8): 504-511.
  2. 2.  Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnencies[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
  3. 3.  Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
  4. 4.  Arruda Mde S, de Camargo Júnior HS. Cesarean scar ectopic pregnancy: a case report[J]. Rev Bras Ginecol Obstet, 2008, 30(10): 518-523.
  5. 5.  楊小蕓, 劉興會. 剖宮產(chǎn)切口瘢痕妊娠臨床特點及治療進展[J]. 中國實用婦科與產(chǎn)科雜志, 2010, 26(8): 585.
  6. 6.  Larsen JV. Solomon MH. Pregn ancy in a uterine seasacculus-an unusual cause of postabortal haemorrhage[J]. S Afr Med J, 1978, 53(4): 142-143.
  7. 7.  Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication[J]. Hum Reprod Update, 2004, 10(6): 515-523.
  8. 8.  Chen HY, Chen SJ, Hsieh FJ. Observation of cesarean section scar by transvaginal ultrasonography[J]. Ultrasound Med Biol, 1990, 16(5): 443-447.
  9. 9.  焦光瓊, 凌梅立, 錢尚萍. 經(jīng)陰道彩色多普勒超聲在診斷剖宮產(chǎn)子宮疤痕妊娠中的價值[J]. 上海醫(yī)學(xué)影像, 2004, 13(1): 16-18.
  10. 10.  Vial Y, Petignat P, Holfeld P. Pregnancy in a cesaream scar[J]. Ultracound Obstet Gynecol, 2000, 16(6): 592-593.
  11. 11.  莊亞玲, 韋浪花, 王雯黃, 等. 應(yīng)用子宮動脈栓塞術(shù)治療剖宮產(chǎn)瘢痕處妊娠[J]. 2008, 88(33): 2372-2374.
  12. 12.  Godin PA, Bassil S, Donnez XJ. An ectopic pregnancy developing in a previous caesarian section scar[J]. Fertil Steri, l997, 67(2): 398-400.
  13. 13.  張燕科, 吳瑞瑾, 林俊. 剖宮產(chǎn)術(shù)后子宮瘢痕處妊娠的早期診斷與治療[J]. 實用婦產(chǎn)科雜志, 2009, 25(12): 750-752.
  14. 14.  Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy[J]. Fertil Steril, 2010, 93(6): 1735-1740.
  15. 15.  Sugawara J, Senoo M, Chisaka H, et al. Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization[J]. Tohoku J Exp Med, 2005, 206(3): 261-265.
  16. 16.  Zhuang Y, Huang L. Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar[J]. Am J Obstet Gynecol, 2009, 201(2): 152. e1-3.