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

【摘要】　 剖宮產(chǎn)術(shù)后子宮切口妊娠（cesarean scar pregnancy，CSP）是指孕卵或胚囊著床于剖宮產(chǎn)術(shù)后子宮切口瘢痕處的一種少見而危險(xiǎn)的異位妊娠，是剖宮產(chǎn)的遠(yuǎn)期并發(fā)癥之一。若診治不當(dāng)，有引起子宮破裂和無法控制陰道大出血的風(fēng)險(xiǎn)，危及患者生命。近年來，隨著微創(chuàng)介入治療技術(shù)的發(fā)展，子宮動脈栓塞術(shù)被廣泛用于CSP的治療，并且可聯(lián)合甲氨蝶呤動脈灌注，迅速有效止血，保留患者子宮和生育功能，為以后清宮治療提供了必要條件，安全有效。現(xiàn)就子宮動脈化療栓塞在CSP中的研究進(jìn)展闡述如下。

引用本文： 王飛,白莉平,褚艷俠,陳亞麗,鄭艾. 子宮動脈化療栓塞在子宮切口妊娠中的研究進(jìn)展. 華西醫(yī)學(xué), 2011, 26(12): 1909-1912. doi: 復(fù)制

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1. 　Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in caesarean section scars: the 8 year experience of one medical centre[J]. Hum Reprod, 2004, 19(2): 278-284.
2. 　Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
3. 　Elgersma O, van der Valk P, Maassen M, et al. Complications and failure of uterine artery embolisation for intractable postpartum haemorrhage[J]. BJOG, 2009, 116(9): 1277-1278.
4. 　Katsumori T, Kasahara T, Oda M, et al. Initial experience of uterine fibroid embolization using porous gelatin sponge particles[J]. Cardiovasc Intervent Radiol, 2011, 34(3): 513-521.
5. 　Smeets AJ, Nijenhuis RJ, van Rooij WJ, et al. Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 943-948.
6. 　Devine K, Stella M, Raja A. Case of the month. Cesarean scar ectopic pregnancy[J]. JAAPA, 2011, 24(7): 70.
7. 　Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
8. 　Kang SY, Park BJ, Kim YW, et al. Surgical management of cesarean scar ectopic pregnancy: hysterotomy by transvaginal approach[J]. Fertil Steril, 2011, 96(1): e25-e28.
9. 　Ash A, Smith A, Maxwell D. Caesarean scar pregnancy[J]. BJOG, 2007, 114(3): 253-263.
10. 　Maymon R, Svirsky R, Smorgick N, et al. Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy[J]. J Ultrasound Med, 2011, 30(9): 1179-1184.
11. 　Wang Y. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar[J]. BJOG, 2006, 113(9): 1035-1038.
12. 　Zhuang YL, Huang LL. 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.e1-152.e3.
13. 　Lian F, Wang Y, Chen W, et al. Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern[J/OL]. Cardiovas Intervent Radiol, 2011[2011-07-20]http://www.springerlink.com/content/co486411or675378/fulltext.pdf.
14. 　Liang F, He J. Methotrexate based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy[J]. Acta Obstet Gynecol Scand, 2010, 89(12): 1592-1594.
15. 　Yang X. Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy[J]. BJOG, 2010, 117(8): 990-996.
16. 　Hirakawa M, Tajima T, Yoshimitsu K, et al. Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes[J]. Am J Roentgenol, 2009, 192(6): 1601-1607.
17. 　Sone M, Osuga K, Shimazu K, et al. Porous gelatin particles for uterine artery embolization: an experimental study of intra-arterial distribution, uterine necrosis, and inflammation in a porcine model[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 1001-1008.
18. 　歐陽欣, 周新春, 康友根, 等. 子宮動脈栓塞治療5例剖宮產(chǎn)后子宮切口妊娠[J]. 重慶醫(yī)學(xué), 2010, 39(17): 2366-2367.
19. 　Li C, Feng D, Jia C, et al. Transcatheter arterial chemoembolization versus systemic methotrexate for the management of cesarean scar pregnancy[J]. Int J Gynecol Obstet, 2011, 113(3): 178-182.
20. 　桑霞, 壽堅(jiān). 經(jīng)子宮動脈栓塞術(shù)治療剖宮產(chǎn)后子宮瘢痕妊娠[J]. 浙江預(yù)防醫(yī)學(xué), 2010, 22(5): 66-67.
21. 　廖紅荔, 王維, 羅賢明, 等. 經(jīng)子宮動脈介入治療剖宮產(chǎn)瘢痕妊娠價(jià)值探討[J]. 醫(yī)學(xué)臨床研究, 2007, 24(6): 980-981.
22. 　馮晴, 賀春花, 萬琪, 等. 子宮動脈栓塞術(shù)在子宮肌瘤治療中的應(yīng)用進(jìn)展[J]. 山東醫(yī)藥, 2011, 51(15): 109-110.
23. 　Siskin GP. Uterine fibroid embolization complication[J]. J Vascul Int Radiol, 2000, 11(1): 38-40.
24. 　Payne JF, Haney MD, Haney AF. Serious complications of uterine artery embolization for conservative treatment of fibroids[J]. Fertil Steril, 2003, 79(1): 128-131.
25. 　徐陽, 傅文莉, 王華. 9例子宮肌瘤介入治療并發(fā)癥的分析及護(hù)理[J]. 中華護(hù)理雜志, 2007, 42(8): 709-710.
26. 　Spies JB, Ascher SA, Roth AR, et al. Uterine artery embolization for leiomyomata[J]. Obstet Gynecol, 2001, 98(1): 29-34.
  1. 1. 　Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in caesarean section scars: the 8 year experience of one medical centre[J]. Hum Reprod, 2004, 19(2): 278-284.
  2. 2. 　Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
  3. 3. 　Elgersma O, van der Valk P, Maassen M, et al. Complications and failure of uterine artery embolisation for intractable postpartum haemorrhage[J]. BJOG, 2009, 116(9): 1277-1278.
  4. 4. 　Katsumori T, Kasahara T, Oda M, et al. Initial experience of uterine fibroid embolization using porous gelatin sponge particles[J]. Cardiovasc Intervent Radiol, 2011, 34(3): 513-521.
  5. 5. 　Smeets AJ, Nijenhuis RJ, van Rooij WJ, et al. Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 943-948.
  6. 6. 　Devine K, Stella M, Raja A. Case of the month. Cesarean scar ectopic pregnancy[J]. JAAPA, 2011, 24(7): 70.
  7. 7. 　Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
  8. 8. 　Kang SY, Park BJ, Kim YW, et al. Surgical management of cesarean scar ectopic pregnancy: hysterotomy by transvaginal approach[J]. Fertil Steril, 2011, 96(1): e25-e28.
  9. 9. 　Ash A, Smith A, Maxwell D. Caesarean scar pregnancy[J]. BJOG, 2007, 114(3): 253-263.
  10. 10. 　Maymon R, Svirsky R, Smorgick N, et al. Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy[J]. J Ultrasound Med, 2011, 30(9): 1179-1184.
  11. 11. 　Wang Y. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar[J]. BJOG, 2006, 113(9): 1035-1038.
  12. 12. 　Zhuang YL, Huang LL. 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.e1-152.e3.
  13. 13. 　Lian F, Wang Y, Chen W, et al. Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern[J/OL]. Cardiovas Intervent Radiol, 2011[2011-07-20]http://www.springerlink.com/content/co486411or675378/fulltext.pdf.
  14. 14. 　Liang F, He J. Methotrexate based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy[J]. Acta Obstet Gynecol Scand, 2010, 89(12): 1592-1594.
  15. 15. 　Yang X. Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy[J]. BJOG, 2010, 117(8): 990-996.
  16. 16. 　Hirakawa M, Tajima T, Yoshimitsu K, et al. Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes[J]. Am J Roentgenol, 2009, 192(6): 1601-1607.
  17. 17. 　Sone M, Osuga K, Shimazu K, et al. Porous gelatin particles for uterine artery embolization: an experimental study of intra-arterial distribution, uterine necrosis, and inflammation in a porcine model[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 1001-1008.
  18. 18. 　歐陽欣, 周新春, 康友根, 等. 子宮動脈栓塞治療5例剖宮產(chǎn)后子宮切口妊娠[J]. 重慶醫(yī)學(xué), 2010, 39(17): 2366-2367.
  19. 19. 　Li C, Feng D, Jia C, et al. Transcatheter arterial chemoembolization versus systemic methotrexate for the management of cesarean scar pregnancy[J]. Int J Gynecol Obstet, 2011, 113(3): 178-182.
  20. 20. 　桑霞, 壽堅(jiān). 經(jīng)子宮動脈栓塞術(shù)治療剖宮產(chǎn)后子宮瘢痕妊娠[J]. 浙江預(yù)防醫(yī)學(xué), 2010, 22(5): 66-67.
  21. 21. 　廖紅荔, 王維, 羅賢明, 等. 經(jīng)子宮動脈介入治療剖宮產(chǎn)瘢痕妊娠價(jià)值探討[J]. 醫(yī)學(xué)臨床研究, 2007, 24(6): 980-981.
  22. 22. 　馮晴, 賀春花, 萬琪, 等. 子宮動脈栓塞術(shù)在子宮肌瘤治療中的應(yīng)用進(jìn)展[J]. 山東醫(yī)藥, 2011, 51(15): 109-110.
  23. 23. 　Siskin GP. Uterine fibroid embolization complication[J]. J Vascul Int Radiol, 2000, 11(1): 38-40.
  24. 24. 　Payne JF, Haney MD, Haney AF. Serious complications of uterine artery embolization for conservative treatment of fibroids[J]. Fertil Steril, 2003, 79(1): 128-131.
  25. 25. 　徐陽, 傅文莉, 王華. 9例子宮肌瘤介入治療并發(fā)癥的分析及護(hù)理[J]. 中華護(hù)理雜志, 2007, 42(8): 709-710.
  26. 26. 　Spies JB, Ascher SA, Roth AR, et al. Uterine artery embolization for leiomyomata[J]. Obstet Gynecol, 2001, 98(1): 29-34.