目的 探讨腹腔镜联合子宫动脉栓塞术(uterine artery embolization,UAE)用于治疗外生型剖宫产术后瘢痕妊娠(cesarean scar pregnancy,CSP)的应用价值。方法 回顾性分析了北京军区总医院2010-01至2015-07收治的14例应用腹腔镜联合UAE治疗的外生型CSP患者的临床表现、诊断、治疗及疗效。结果 术前行UAE的13例患者腹腔镜下首次治疗成功,术后2～5 d复查血HCG,HCG检测结果为25.9～5657.0 mU/L,平均为2094.5 mU/L;同术前相比,平均下降89.64%±11.55%。术前未行UAE的1例患者术中因出现大出血而急诊输血+中转开腹行瘢痕病灶切除术+子宫动脉栓塞术。14例均治愈出院且无复发。结论 腹腔镜联合UAE治疗外生型CSP较直观、安全、有效,术前应用UAE能有效减少术中出血,术中应用UAE能有效控制出血。
Abstract
Objective To analyze the application value of laparoscopy combined uterine artery embolization (UAE) for the treatment of exogenous cesarean scar pregnancy.Methods We retrospectively analyzed the clinical manifestations, diagnosis, treatment and curative effect in the 14 cases of exogenous cesarean scar pregnancy treated by laparoscopy combined with uterine artery embolization,admitted in Beijing Military General Hospital from January 2010 to July 2015.Results Of the 14 cases, 13 cases of laparoscopic treatment ended up success fully for the first time who underwent were operated UAE before the operation. The blood HCG test result 2-5 d postoperative on was 25.9-5657.0 mU/L with an average of 2094.5 mU/L, on average lower by 89.64%±11.55% compared with the preoperative HCG test Results. One patient without preoperative UAE had massive hemorrhage received emergent blood and transferred to transfusion laparotomic scar lesion resection + uterine artery embolization. All the 14 patients were cured and discharged, and none of them was re-admitted.Conclusions Laparoscopy combined with uterine artery embolization (UAE) for the treatment of exogenous CSP is intuitive,safe,effective, and preoperative application of UAE can effectively reduce the intraoperative bleeding. Intraoperative application of UAE can effectively control the bleeding.
关键词
外生型剖宫产瘢痕妊娠 /
腹腔镜 /
子宫动脉栓塞术
Key words
exogenous cesarean scar pregnancy /
laparoscopy /
uterine artery embolization
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参考文献
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