子宫动脉栓塞后清除剖宫产瘢痕妊娠的方式与时机选择

doi:10.3969/j.issn.1674-8115.2021.11.019

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (11): 1524-1528.doi: 10.3969/j.issn.1674-8115.2021.11.019

子宫动脉栓塞后清除剖宫产瘢痕妊娠的方式与时机选择

俞丽萍(), 薛卓维, 滕银成()

上海交通大学附属第六人民医院妇产科，上海 200233

出版日期:2021-11-28 发布日期:2021-10-22
通讯作者: 滕银成 E-mail:yuliping_iris@163.com;ycteng@sjtu.edu.cn
作者简介:俞丽萍（1994—），女，硕士生；电子信箱：yuliping_iris@163.com。
基金资助:
上海市卫生和计划生育委员会科研课题(201640373)

Methods and timing of removing cesarean scar pregnancy after uterine artery embolization

Li-ping YU(), Zhuo-wei XUE, Yin-cheng TENG()

Department of Obstetrics and Gynecology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China

Online:2021-11-28 Published:2021-10-22
Contact: Yin-cheng TENG E-mail:yuliping_iris@163.com;ycteng@sjtu.edu.cn
Supported by:
Scientific Research Project of Shanghai Health and Family Planning Commission(201640373)

摘要/Abstract

摘要：

剖宫产瘢痕妊娠（cesarean scar pregnancy，CSP）是一种严重威胁育龄女性生命安全、导致其生育功能丧失的特殊类型异位妊娠。子宫动脉栓塞术（uterine artery embolization，UAE）是用于治疗CSP的辅助手段，其可迅速阻断病灶血供，减少出血量。临床上，常采用UAE的联合方案对CSP进行治疗，如联合药物治疗（甲氨蝶呤等）、手术治疗（清宫术，宫腔镜术，及经腹、腹腔镜、经阴道等途径）来清除妊娠物。目前，针对不同类型的CSP，如何选择UAE联合治疗方案及清除妊娠物的时机同时兼顾治愈率和安全性是临床医师面临的问题。且国内外对CSP的治疗方案尚无明确的指南和统一的标准。文章回顾了近年来国内外文献，对UAE联合不同治疗方式的效果及清除妊娠物的时机进行综述，以期为后续的研究提供参考。

关键词: 剖宫产瘢痕妊娠, 子宫动脉栓塞术, 清除, 方式与时机

Abstract:

Cesarean scar pregnancy (CSP) is a special type of ectopic pregnancy that seriously threatens the life safety of women of childbearing age and leads to the loss of reproductive function. Uterine artery embolization (UAE) is an auxiliary method for the treatment of CSP, which can quickly block the blood supply to the lesion and reduce bleeding. Clinically, the combined scheme of UAE is often used to treat CSP, such as combined drug treatment (methotrexate, etc.), and surgical treatment (curettage, hysteroscopy, transabdominal, laparoscopic, transvaginal and other ways) to remove pregnancy. At present, for different types of CSP, how to choose the combination treatment scheme of UAE and the time to remove pregnancy while taking into account the cure rate and safety is a problem faced by clinicians. And there are no clear guidelines and unified standards for the treatment of CSP at home and abroad. This paper reviews the literature at home and abroad in recent years, and summarizes the effect of UAE combined with different treatment methods and the timing of removing pregnancy, in order to provide reference for follow-up research.

Key words: cesarean scar pregnancy (CSP), uterine artery embolization (UAE), removal, method and timing

中图分类号:

R714.2

俞丽萍, 薛卓维, 滕银成. 子宫动脉栓塞后清除剖宫产瘢痕妊娠的方式与时机选择[J]. 上海交通大学学报(医学版), 2021, 41(11): 1524-1528.

Li-ping YU, Zhuo-wei XUE, Yin-cheng TENG. Methods and timing of removing cesarean scar pregnancy after uterine artery embolization[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(11): 1524-1528.

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子宫动脉栓塞后清除剖宫产瘢痕妊娠的方式与时机选择

Methods and timing of removing cesarean scar pregnancy after uterine artery embolization

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