【摘要】 目的探讨子宫动脉栓塞术治疗妊娠中期剖宫产瘢痕部位妊娠(CSP)的疗效。方法回顾性分析2013年1月至2018年6月中国医科大学附属盛京医院(盛京医院)收治的29例妊娠中期CSP患者的临床资料,根据患者首诊医院不同分为两组:A组14例,均首诊于基层医院,行药物引产术,因引产过程中大量阴道流血或引产失败转入盛京医院继续治疗;B组15例,首诊于盛京医院,于引产术前均先行子宫动脉栓塞术。比较两组治疗效果。结果两组患者年龄、孕周、既往剖宫产次数、距前次剖宫产时间及既往人工流产次数比较差异均无统计学意义(P>0.05)。B组手术时间较A组缩短[(54.00±31.19)min vs.(105.07±67.92)min],术中出血量较A组减少[(73.33±24.57)mL vs.(869.29±276.99)m L],术后阴道流血时间较A组缩短[(4.46±1.06)d vs.(6.79±2.08)d],住院时间较A组缩短[(8.80±1.74)d vs.(14.57±4.54)d],输血率明显低于A组(0 vs.78.6%),子宫保留率明显高于A组(100%vs.71.4%),差异均有统计学意义(P<0.05)。结论子宫动脉栓塞术治疗妊娠中期CSP可以有效缩短手术时间、减少术中出血量及提高子宫保留率。更多还原

【Abstract】 Objective To analyse the clinical value of uterine artery embolization(UAE)in the treatment of caesarean scar pregnancy(CSP)in the second trimester of pregnancy.Methods The clinical data of 29 cases treated from January2013 to June 2018 in Shengjing Hospital of China Medical University was retrospective analyzed.The patients were divided into group A(14 cases)and group B(15 cases)according to the first hospital. visitedPatients in group A first visited basic local hospitals and underwent drug-induced labor.Due to a large amount of vaginal bleeding or failure of induced labor,they were transferred to our hospital for further treatment. Patients in group B first visited our hospital and were treated by UAE before induced labor. The therapeutic effect was compared between the two groups.Results There was no statistical difference between the two groups in age,gestational weeks,number of caesarean section,period of time from previous caesarean section,or number of previous induced abortions(P>0.05).The average operation time of group B was shorter than that of group A[(54.00±31.19)min vs.(105.07±67.92)min,P<0.05]. The average intraoperative bleeding of group B was less than that of group A[(73.33±24.57)mL vs.(869.29±276.99)mL,P<0.05].Postoperative vaginal bleeding time of group B was shorter than that of group A[(4.46±1.06)d vs.(6.79±2.08)d,P<0.05].Average hospitalization time of group B was shorter than that of group A[(8.80±1.74)d vs.(14.57±4.54)d,P<0.05].The transfusion rate of group B was lower than that of group A[0 vs.78.6%,P<0.05].The uterine retention rate of group B was higher than group A[100% vs.71.4%,P<0.05].Conclusion UAE has significant clinical value in the treatment of CSP in the second trimester of pregnancy.It can reduce operation time,intraoperative bleeding volume and increase uterine retention rate.更多还原