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目的:探讨子宫动脉灌注化疗加栓塞在宫颈妊娠治疗中的临床应用。方法:对15例停经45～92天的宫颈妊娠患者行子宫动脉MTX或卡铂灌注化疗加栓塞术,术后观察不同时间的病灶大小、血HCG值变化及结局。结果:14例行一次子宫动脉灌注化疗加栓塞,1例行2次子宫动脉灌注化疗加栓塞,术后血HCG值均明显下降,病灶大小与血HCG值变化无关。14例安全行清宫术,1例因清宫术再出血行第2次灌注加栓塞。结论:子宫动脉灌注加栓塞能够迅速、有效杀灭胚胎,制止宫颈妊娠出血,使血HCG值快速下降,降低清宫时的风险,是治疗宫颈妊娠安全、有效的方法。同时,在化疗药物的选择、清宫时机的把握等方面尚需进一步研究。
Objective: To investigate the clinical application of uterine arterial infusion chemotherapy and embolization in the treatment of cervical pregnancy. Methods: 15 cases of cervical pregnancy 45 ~ 92 days of menopause patients underwent uterine artery MTX or carboplatin chemotherapy and embolization, after surgery to observe the size of the lesion at different times, changes in blood HCG value and outcome. Results: 14 cases underwent primary uterine arterial infusion chemotherapy and embolization, and 1 case underwent uterine arterial infusion chemotherapy and embolization. The postoperative serum HCG values were significantly decreased. The size of the lesion was not related to the change of blood HCG. 14 cases of curettage curettage, 1 case of rebleeding due to curettage the second perfusion and embolization. Conclusion: Uterine arterial infusion plus embolization can quickly and effectively kill embryos, stop the bleeding of cervical pregnancy, rapidly decrease the blood HCG value and reduce the risk of clearing the cervix. It is a safe and effective method for the treatment of cervical pregnancy. At the same time, the choice of chemotherapy drugs, the timing of the Qing government still need further study.