中国实用妇科与产科杂志

• 专题笔谈 • 上一篇    下一篇

剖宫产瘢痕妊娠的介入治疗

  

  1. 四川大学华西第二医院妇产科,四川 成都 610041
  • 出版日期:2018-08-02 发布日期:2018-08-09
  • 通讯作者: 赵霞

Transcatheter embolization therapies for caesarean scar pregnancy.

  1. Department of Gynecology and Obstetrics,West China Second Hospital,Sichuan University,Chengdu 610041,China
  • Online:2018-08-02 Published:2018-08-09

摘要:

血管性介入治疗已成为剖宫产瘢痕妊娠(CSP)治疗的重要手段,除了作为CSP发生大出血时的急救措施外,其在联合清宫术、宫腔镜等的综合方案中体现了重要价值,具有快速有效止血、杀胚、降低出血风险、提高后续手术成功率等优势。但介入治疗为侵入性操作,有并发症风险,临床应用时应把握指征。现有研究表明,病灶血供丰富是选择预防性介入治疗的重要参考依据。目前,介入术后进行外科操作的时机尚存在争议,大部分学者选择在24~72h内施行清除病灶手术。因此,亟待进行大样本、多中心、前瞻性、随机的临床研究,以更全面、客观地指导介入治疗在CSP诊治中的合理应用。

关键词: 剖宫产瘢痕妊娠, 介入治疗, 子宫动脉栓塞术, 出血风险, 联合治疗

Abstract:

Transcatheter embolization therapies play significant roles in treatment of caesarean scar pregnancy.Uterine artery embolization has a great clinical value in prevention of massive hemorrhage.It is widely used in comprehensive treatment for CSP,which combines UAE with surgical treatment such as curettage and hysterectomy.As some studies report,CSP with blood flow signals is one of the most important indications for preventive UAE.Even though most of current researches have reported undergoing surgery in 24-72 hours after UAE,the best interval between UAE and following surgery is still an ongoing topic of research.Thus,more advancing researches are needed to guide the rational application of transcatheter embolization therapies.

Key words: caesarean scar pregnancy, uterine artery embolization, hemorrhage, combined treatment

中图分类号: