Li Yang, Wang Weiwen, Yang Ting, Wei Xing, Yang Xiaofeng
Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Int J Gynaecol Obstet. 2016 Aug;134(2):202-7. doi: 10.1016/j.ijgo.2015.12.006. Epub 2016 Apr 8.
To evaluate combining uterine artery embolization (UAE) with other treatments for cesarean scar pregnancy (CSP).
A retrospective study included patients attending the First affiliated Hospital of Xi'an Jiaotong University, China, between March 1, 2009 and March 31, 2014, who were diagnosed with CSP. Patients were classified by ultrasonography as having endogenous CSP (CSP type I [CSP-I]) or exogenous CSP (CSP type II [CSP-II]). Patient outcomes were compared between patients who underwent treatment that included or excluded UAE. Patient records were reviewed and patients were interviewed by telephone to report on recovery following treatment.
In total, 52 patients met the inclusion criteria. In patients with CSP-I, the blood loss, length of hospital stay, and time before restoration of normal β human chorionic gonadotropin levels were significantly higher in patients who were treated with methotrexate combined with dilatation and curettage compared with those treated with UAE combined with dilatation and curettage (P<0.05). In patients with CSP-II, blood loss was lower in patients treated with UAE combined with excision compared with excision alone (P<0.001).
Incorporating UAE in the treatment of CSP-I and CSP-II was safe; CSP should be properly classified to select the appropriate treatment.
评估子宫动脉栓塞术（UAE）联合其他治疗方法用于剖宫产瘢痕妊娠（CSP）的效果。
一项回顾性研究纳入了2009年3月1日至2014年3月31日在中国西安交通大学第一附属医院就诊且被诊断为CSP的患者。通过超声检查将患者分为内生性CSP（CSP I型[CSP-I]）或外生性CSP（CSP II型[CSP-II]）。比较接受包含或不包含UAE治疗的患者的结局。查阅患者记录并通过电话访谈患者以报告治疗后的恢复情况。
共有52例患者符合纳入标准。在CSP-I患者中，与接受UAE联合刮宫术治疗的患者相比，接受甲氨蝶呤联合刮宫术治疗的患者的失血量、住院时间以及β人绒毛膜促性腺激素水平恢复正常前的时间显著更高（P<0.05）。在CSP-II患者中，与单纯切除术相比，接受UAE联合切除术治疗的患者失血量更低（P<0.001）。
将UAE纳入CSP-I和CSP-II的治疗是安全的；应正确分类CSP以选择合适的治疗方法。
