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目的探讨选择性子宫动脉化疗栓塞术联合B超引导下清宫术在治疗子宫瘢痕妊娠中的临床价值。方法回顾分析我院2010年1月~2012年12月子宫瘢痕妊娠20例,行子宫动脉化疗栓塞术后超声引导下清宫,记录手术时阴道出血量,并随访血β-hCG及超声。结果 20例瘢痕妊娠化疗栓塞术后,清宫术中出血5~150ml。术后复查血β-hCG进行性下降,1个月后复查血β-hCG降至正常,超声示孕囊消失,均成功保留子宫及生育功能。结论子宫动脉化疗栓塞术联合B超引导下清宫治疗瘢痕妊娠方法安全、有效、创伤小、无明显并发症,能避免盲目刮宫引起的大出血,降低子宫切除率,是瘢痕妊娠特别是合并大量出血或预防高危大出血的首选治疗方法。
Objective To investigate the clinical value of selective uterine artery chemoembolization combined with B-guided Qing Gong operation in the treatment of uterine scar pregnancy. Methods 20 cases of uterine scar pregnancy in our hospital from January 2010 to December 2012 were retrospectively analyzed. Uterine arterial chemoembolization was performed under the guidance of ultrasonography. The amount of vaginal bleeding was recorded and the blood β-hCG and ultrasound were followed up. Results 20 cases of scar pregnancy and chemotherapy after embolization, curettage bleeding 5 ~ 150ml. Postoperative blood β-hCG decreased progressively, 1 month after the return of blood β-hCG dropped to normal ultrasound showed gestational sac disappeared, were successfully retained uterine and reproductive function. Conclusion Uterine artery chemoembolization combined with B-guided lower hysteroscopic treatment of scar pregnancy method is safe, effective, less trauma, no obvious complications, can avoid blind curettage-induced bleeding, reduce the rate of hysterectomy, is a scar pregnancy, especially with massive bleeding or Prevention of high-risk bleeding the preferred treatment.