[1]陈金亮,梅海炳.首次和再次瘢痕妊娠介入治疗临床效果分析[J].介入放射学杂志,2021,30(08):820-823.
 CHEN Jinliang,MEI Haibing..Interventional therapy for the first and second cesarean scar pregnancy: analysis of clinical curative effect[J].journal interventional radiology,2021,30(08):820-823.
点击复制

首次和再次瘢痕妊娠介入治疗临床效果分析()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年08
页码:
820-823
栏目:
临床研究
出版日期:
2021-08-25

文章信息/Info

Title:
Interventional therapy for the first and second cesarean scar pregnancy: analysis of clinical curative effect
作者:
陈金亮 梅海炳
Author(s):
CHEN Jinliang MEI Haibing.
Department of Radiology, Ningbo Municipal Women and Children’s Hospital, Ningbo, Zhejiang Province 315010, China
关键词:
【关键词】 剖宫产瘢痕妊娠 子宫动脉栓塞术 疗效
文献标志码:
A
摘要:
【摘要】 目的 探讨介入治疗联合清宫术与宫腔镜手术治疗剖宫产瘢痕妊娠(CSP)出血情况,评价介入治疗对首次和再次CSP的效果。 方法 收集宁波市妇女儿童医院2014年1月至2019年12月收治的88例CSP患者临床资料。其中33例患者2次CSP接受2次介入治疗联合清宫术(A组),55例患者首次CSP未介入治疗直接接受宫腔镜手术(B组)。观察指标:两组手术出血量,A组再次CSP二次介入治疗与首次CSP介入治疗手术情况(子宫供血血管、栓塞血管、血管破裂、曝光时间、手术时间),术后清宫出血量、清宫成功率。 结果 A组、B组术中出血量分别为(40.38±87.30) mL、(69.27±68.63) mL,A组出血量较少(P=0.048)。再次CSP二次介入治疗与首次CSP介入治疗相比,双侧子宫动脉供血比率(48.5%对100%,P<0.01)、双侧子宫动脉栓塞比率(42.4%对97%,P<0.01)均显著较低,超选择插管和栓塞过程中血管易破裂(15%对0%,P=0.02)、曝光时间[(5.26±1.67) min对(2.72±1.02) min,P<0.001]、手术时间[(61.94±15.85) min对 (40.45±9.49) min,P<0.01]均明显延长;介入术后清宫过程中出血量[(74.70±114.23) mL对(6.06±2.08) mL,P=0.01]明显增多,清宫成功率(87.9%对100%,P=0.04)较低。 结论 清宫术前介入栓塞可有效减少CSP治疗中出血,但再次CSP行二次介入治疗手术难度较大,术后清宫过程中出血风险仍较高,清宫术前需做好充分准备。

参考文献/References:

[1] 金 力. 剖宫产术后子宫瘢痕妊娠诊治专家共识(2016)[J]. 中华妇产科杂志, 2016, 51:568- 572.
[2] Timor- Tritsch IE, Monteagudo A, Cali G,et al. Cesarean scar pregnancy[J]. Obstet Gynecol Clin North Am, 2019, 46:813- 828.
[3] 朱志韬, 孙志先, 祖茂衡,等. 子宫动脉栓塞术预防疤痕妊娠清宫大出血的临床价值[J]. 中华介入放射学电子杂志, 2017, 5:13- 16.
[4] 李 奎, 颜国辉, 邹 煜. 子宫动脉栓塞与甲氨蝶呤治疗不同MRI分型的剖宫产术后疤痕妊娠的疗效评价[J]. 中华介入放射学电子杂志, 2017, 5:128- 134
[5] 陈正云, 李小永, 赵 达, 等. 宫腔镜手术终止早期Ⅱ型剖宫产术后子宫瘢痕妊娠的临床研究[J]. 中华妇产科杂志, 2017, 52:669- 674.
[6] 欧阳振波, 段 慧, 刘 萍, 等. 人正常子宫动脉血管网的解剖及临床意义[J]. 中国妇幼保健, 2012, 27:786- 789.
[7] 董芳芳, 戚 健, 张 伟. 二次瘢痕妊娠介入治疗2例[J]. 河北医药, 2013, 35:1759- 1760.
[8] 冯志鹏, 张建好, 韩新巍. 卵巢动脉栓塞对子宫疾病介入治疗的意义[J]. 介入放射学杂志, 2019, 28:692- 695.
[9] 申 景, 刘玉娥, 肖 亮, 等. 髂外动脉有关的产后出血一例报道并文献复习[J]. 介入放射学杂志, 2014, 23:536- 538.

相似文献/References:

[1]程曙,王士甲,张国福.子宫动脉栓塞在治疗子宫腺肌病中占有重要地位[J].介入放射学杂志,2010,(12):925.
 CHENG Shu,WANG Shi-jia,ZHANG Guo-fu..The significant value of uterine artery embolization in treating adenomyosis[J].journal interventional radiology,2010,(08):925.
[2]宋 杰,王黎洲,李 兴,等. 前置胎盘剖宫产术中行子宫动脉栓塞术对防治产后出血的应用[J].介入放射学杂志,2013,(05):418.
 SONG Jie,WANG Li? zhou,LI Xin,et al. Uterine artery embolization performed during cesarean section due to placenta previa: its application in preventing postpartum hemorrhage[J].journal interventional radiology,2013,(08):418.
[3]黄加胜,张慕玲,束晓明,等.预防性子宫动脉栓塞在产科疾病中的应用[J].介入放射学杂志,2013,(12):980.
 HUANG Jia? sheng,ZHANG Mu? ling,SHU Xiao? ming,et al. Clinical application of prophylactic uterine artery embolization in obstetrical diseases[J].journal interventional radiology,2013,(08):980.
[4]梁 昊,闫 磊,韩新巍,等.髂外动脉造影在瘢痕子宫产后出血子宫动脉栓塞术中应用价值[J].介入放射学杂志,2018,27(05):481.
 LIANG Hao,YAN Lei,HAN Xinwei,et al.The application value of external iliac artery angiography in uterine artery embolization for postpartum hemorrhage in delivery women with scarred uterus[J].journal interventional radiology,2018,27(08):481.
[5]江苏省妇幼保健协会妇产介入分会、江苏省医学会介入医学分会妇儿学组.剖宫产瘢痕妊娠诊断与介入治疗江苏共识[J].介入放射学杂志,2018,27(10):911.
 Intervention Branch of Jiangsu Province Maternal and Child Health Association,Women and Children Section of Interventional Medicine Branch of Jiangsu Medical Association.Jiangsu consensus on the diagnosis and interventional therapy of cesarean scar pregnancy Obstetrics and Gynecology[J].journal interventional radiology,2018,27(08):911.
[6]冯志鹏,张建好,韩新巍,等.卵巢动脉栓塞在子宫出血性疾病介入治疗中的意义[J].介入放射学杂志,2019,28(08):778.
 FENG Zhipeng,ZHANG Jianhao,HAN Xinwei,et al.The significance of ovarian artery embolization in interventional therapy of uterine hemorrhagic diseases[J].journal interventional radiology,2019,28(08):778.
[7]谢璇丞,范宏杰,赵 卫,等.子宫肌瘤介入治疗现状及研究进展[J].介入放射学杂志,2019,28(09):905.
 XIE Xuancheng,FAN Hongjie,ZHAO Wei,et al.Interventional treatment of uterine fibroids: its current situation and research progress[J].journal interventional radiology,2019,28(08):905.
[8]阎冰洁,李 鹏,徐晓菊,等.两种不同功率高强度聚焦超声治疗子宫瘢痕妊娠的比较[J].介入放射学杂志,2021,30(06):580.
 YAN Bingjie,LI Peng,XU Xiaoju,et al.Two different power high-intensive focused ultrasound for cesarean scar pregnancy: comparison of curative effect[J].journal interventional radiology,2021,30(08):580.
[9]王艳丽,赵 毅,徐 苗,等.氢吗啡酮自控镇痛应用于子宫肌瘤动脉栓塞术的有效性和安全性[J].介入放射学杂志,2022,31(10):962.
 WANG Yanli,ZHAO Yi,XU Miao,et al.Application of patient-controlled intravenous analgesia using hydromorphone in arterial embolization of uterine fibroids: evaluation of its efficacy and safety[J].journal interventional radiology,2022,31(08):962.
[10]张 凯,任红瑞,马 祯,等.介入栓塞术在子宫动脉假性动脉瘤中的应用及疗效分析[J].介入放射学杂志,2022,31(11):1073.
 ZHANG Kai,REN Hongrui,MA Zhen,et al.Application of interventional embolization in treating uterine artery pseudoaneurysm and analysis of its effect[J].journal interventional radiology,2022,31(08):1073.
[11]陈 毅,谢春明,杨敏玲,等. 子宫动脉栓塞术在剖宫产术后子宫瘢痕妊娠治疗中的应用[J].介入放射学杂志,2012,(05):410.
 ,,et al. The application of uterine artery embolization for the treatment of uterine scar pregnancy after cesarean section[J].journal interventional radiology,2012,(08):410.
[12]张 伟,王莉杰,王 觅.子宫动脉栓塞术治疗有异常供血的剖宫产瘢痕妊娠临床研究[J].介入放射学杂志,2020,29(07):668.
 ZHANG Wei,WANG Lijie,WANG Mi..Uterine artery embolization for the treatment of cesarean scar pregnancy with abnormal blood supply: a clinical study[J].journal interventional radiology,2020,29(08):668.
[13]张雅清,李 红.子宫瘢痕妊娠影像学诊断和介入治疗现状[J].介入放射学杂志,2020,29(10):1052.
 ZHANG Yaqing,LI Hong..Current situation of imaging diagnosis and interventional therapy of cesarean scar pregnancy[J].journal interventional radiology,2020,29(08):1052.
[14]陈 竺,谭廷廷,孙秋蕾,等.影响剖宫产瘢痕妊娠治疗效果的危险因素分析[J].介入放射学杂志,2021,30(10):1048.
 CHEN Zhu,TAN Tingting,SUN Qiulei,et al.Analysis of risk factors influencing the therapeutic effect of cesarean scar pregnancy[J].journal interventional radiology,2021,30(08):1048.

备注/Memo

备注/Memo:
(收稿日期:2020- 07- 17)
(本文编辑:边 佶)
更新日期/Last Update: 2021-08-18