[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.
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首次和再次瘢痕妊娠介入治疗临床效果分析()

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《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.

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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