• 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(jì)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(xiǎn)、降低子宮切除風(fēng)險(xiǎn)，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

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(diǎn)及治療進(jìn)展[J]. 中國實(shí)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(jià)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(shí)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(diǎn)及治療進(jìn)展[J]. 中國實(shí)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(jià)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(shí)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.