子宫动脉栓塞术治疗剖宫产术后子宫疤痕妊娠30例临床分析

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1、浙}J：人。■帧卜学位论义中义摘篮子宫动脉栓塞术治疗剖官产术后子宫疤痕妊娠30例临床分析浙江大学医学院临床医学7年制妇产科学专业硕士研究生闫鼎鼎导师黄丽丽中文摘要目的探讨子宫动脉栓塞术在治疗剖宫产术后子宫疤痕妊娠中的疗效及安全性．方法回顾性分析2004—2007年收治的剖宫产术后子宫疤痕妊娠30例患者的临床资料，30例患者既往均有子宫下段剖宫产史，均有停经史和或不规则无痛性阴道出血，所有患者术前均经超声检查明确诊断。28例刮宫术前均预防性行子宫动脉栓塞术，2例行药物治疗后直接刮宫．结果28例预防性行子宫动脉栓塞术的患者中，25例(25／28)刮宫术中出血<

2、200ml；2例药物后直接刮宫的患者均因术中或术后24J]、时内持续性大出血予急诊行子宫动脉栓塞术。30例患者均成功地保留了生育功能。所有患者血HCG均在术后9～35天恢复正常，1～2个月后均恢复正常月经，无明显并发症。结论利用子宫动脉栓塞术治疗剖官产术后子宫疤痕妊娠具有降低大出血风险，保留妇女生育功能，疗效确切，安全、副反应轻的优点，对剖宫产术后子宫疤痕妊娠可作为首选的治疗方法。关键词：剖宫产；子宫疤痕妊娠；子宫动脉栓塞术；刮宫术Clinicalanalysisof30casesofcesareanscarpregnancywiththetreatmen

3、tofuterinearteryembolizationPostgraduate：YanDingdingTutor：HuangLiliAbstractObjectiveToevaluatethesecurityandeffectivenessoftheuterinearteryembolization(UAE)inthetreatmentofcesareanscarpregnancy．MethodFrom2004to2007，30patientsundergoinguterinearteryembolizationfortheircesareanSCarp

4、regnancywerestudiedretrospectively．30patientshadprevioushistoryoflowersegmentcesareansection．Allofthemhadamenorrheawithorwithoutpainlessirregularvaginalbleeding．30caseswerealldiagnosedbyultrasonography．28casesweretreatedwithcurettageafteruterinearteryembolization，2casewastreatedwi

5、thcurettageaftermedicinetreatment．ResultAmongthe28caseswhoweretreatedwithcurettageafteruterinearteryembolization，25cases(25／28)hadbleeding<200mlduringcurettage；2caseswhoweretreatedwithcurettageaftermedicinetreatmentunderwentemergencyuterinearteryembolizationbecauseofpersistentblee

6、dingin24hoursaftercurettage．Allofthe30patientsweresuccessfullyretainedthereproductiveffanction，andtheserumhCGreturnedtothenormallevelin9～35daysaftercurettage．After1～2months，theyhadnormalmenstruationwithriOsignificantcomplications．ConclusionUterinearteryembolizationisaneffective，sa

7、feandminimallyinvasivemethodwithlowriskofheavybleedingforthetreatmentofcesareanscar浙iJ：人学坝Ij学位论文英文摘要pregnancy，whichshouldbethefirstchoiceforpatientswithcesareanscarpregnancy．Keywords：cesareansection；cesareanscarpregnancy；uterinearteryembolization；curettageIV浙江大学研究生学位论文独创性声明本人声明所呈交

8、的学位论文是本人在导师指导。F进行的研究工作及取得的研究成果。除了