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目的探讨和分析子宫动脉化疗栓塞术(uterine arterial chemoembolization,UACE)+经阴道剖宫产瘢痕妊娠病灶切除术治疗剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)的临床应用效果。方法选取2014年10月至2016年10月在内蒙古医科大学附属医院行综合治疗的CSP患者共22例,观察患者的手术时间、术中出血量、血β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)下降情况及恢复正常时间、术后并发症情况、月经复潮时间以及总住院时间等,观察治疗效果。结果患者在手术中出血量少,手术时间短,术后住院时间短,手术成功率高,只有1例术中发生大出血改为开腹手术,但均治愈并成功保留子宫。手术以后监测患者血β-hCG数值均下降至正常。除出现下腹部疼痛、臀部疼痛、发热外,无其他并发症。结论 UACE联合经阴道剖宫产瘢痕妊娠病灶切除术治疗CSP具有微创、安全、有效的特点,是治疗CSP的理想手术方法,值得临床推广。
Objective To investigate and analyze the clinical effect of uterine arterial chemoembolization (UACE) + transvaginal cesarean scar pregnancy in the treatment of cesarean scar pregnancy (CSP). Methods A total of 22 CSP patients were selected from the Department of General Hospital of Inner Mongolia Medical University between October 2014 and October 2016. The operation time, blood loss, blood β-human chorionic gonadotropin human chorionic gonadotropin, β-hCG) decline and recovery time, postoperative complications, menstruation, recuperation time and total length of stay, etc., to observe the therapeutic effect. Results The patients had less bleeding during operation, shorter operation time, shorter postoperative hospital stay, and higher success rate of operation. Only one case of intraoperative hemorrhage was changed to laparotomy, but all were cured and the uterus was successfully preserved. The blood levels of β-hCG in patients monitored after surgery decreased to normal. In addition to lower abdominal pain, buttocks, pain, fever, no other complications. Conclusions UACE combined with transvaginal cesarean scar excision of cesarean section for the treatment of CSP has the characteristics of minimally invasive, safe and effective. It is an ideal surgical treatment for CSP and is worthy of clinical promotion.