子宫动脉化疗栓塞在子宫切口妊娠中的研究进展_West China Medical Journal

Authors：

王飞 , 白莉平 , 褚艳侠 , 陈亚丽 ,  郑艾

Corresponding author：

郑艾, Email: 444120195@qq.com

Keywords：

剖宫产; 子宫切口妊娠; 子宫动脉栓塞; 甲氨蝶呤; 清宫术

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【摘要】　剖宫产术后子宫切口妊娠（cesarean scar pregnancy，CSP）是指孕卵或胚囊着床于剖宫产术后子宫切口瘢痕处的一种少见而危险的异位妊娠，是剖宫产的远期并发症之一。若诊治不当，有引起子宫破裂和无法控制阴道大出血的风险，危及患者生命。近年来，随着微创介入治疗技术的发展，子宫动脉栓塞术被广泛用于CSP的治疗，并且可联合甲氨蝶呤动脉灌注，迅速有效止血，保留患者子宫和生育功能，为以后清宫治疗提供了必要条件，安全有效。现就子宫动脉化疗栓塞在CSP中的研究进展阐述如下。

Citation： 王飞,白莉平,褚艳侠,陈亚丽,郑艾. 子宫动脉化疗栓塞在子宫切口妊娠中的研究进展. West China Medical Journal, 2011, 26(12): 1909-1912. doi: Copy

1.	Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in caesarean section scars: the 8 year experience of one medical centre[J]. Hum Reprod, 2004, 19(2): 278-284.
2.	Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
3.	Elgersma O, van der Valk P, Maassen M, et al. Complications and failure of uterine artery embolisation for intractable postpartum haemorrhage[J]. BJOG, 2009, 116(9): 1277-1278.
4.	Katsumori T, Kasahara T, Oda M, et al. Initial experience of uterine fibroid embolization using porous gelatin sponge particles[J]. Cardiovasc Intervent Radiol, 2011, 34(3): 513-521.
5.	Smeets AJ, Nijenhuis RJ, van Rooij WJ, et al. Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 943-948.
6.	Devine K, Stella M, Raja A. Case of the month. Cesarean scar ectopic pregnancy[J]. JAAPA, 2011, 24(7): 70.
7.	Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
8.	Kang SY, Park BJ, Kim YW, et al. Surgical management of cesarean scar ectopic pregnancy: hysterotomy by transvaginal approach[J]. Fertil Steril, 2011, 96(1): e25-e28.
9.	Ash A, Smith A, Maxwell D. Caesarean scar pregnancy[J]. BJOG, 2007, 114(3): 253-263.
10.	Maymon R, Svirsky R, Smorgick N, et al. Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy[J]. J Ultrasound Med, 2011, 30(9): 1179-1184.
11.	Wang Y. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar[J]. BJOG, 2006, 113(9): 1035-1038.
12.	Zhuang YL, Huang LL. Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar[J]. Am J Obstet Gynecol, 2009, 201(2): 152.e1-152.e3.
13.	Lian F, Wang Y, Chen W, et al. Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern[J/OL]. Cardiovas Intervent Radiol, 2011[2011-07-20]http://www.springerlink.com/content/co486411or675378/fulltext.pdf.
14.	Liang F, He J. Methotrexate based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy[J]. Acta Obstet Gynecol Scand, 2010, 89(12): 1592-1594.
15.	Yang X. Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy[J]. BJOG, 2010, 117(8): 990-996.
16.	Hirakawa M, Tajima T, Yoshimitsu K, et al. Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes[J]. Am J Roentgenol, 2009, 192(6): 1601-1607.
17.	Sone M, Osuga K, Shimazu K, et al. Porous gelatin particles for uterine artery embolization: an experimental study of intra-arterial distribution, uterine necrosis, and inflammation in a porcine model[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 1001-1008.
18.	欧阳欣, 周新春, 康友根, 等. 子宫动脉栓塞治疗5例剖宫产后子宫切口妊娠[J]. 重庆医学, 2010, 39(17): 2366-2367.
19.	Li C, Feng D, Jia C, et al. Transcatheter arterial chemoembolization versus systemic methotrexate for the management of cesarean scar pregnancy[J]. Int J Gynecol Obstet, 2011, 113(3): 178-182.
20.	桑霞, 寿坚. 经子宫动脉栓塞术治疗剖宫产后子宫瘢痕妊娠[J]. 浙江预防医学, 2010, 22(5): 66-67.
21.	廖红荔, 王维, 罗贤明, 等. 经子宫动脉介入治疗剖宫产瘢痕妊娠价值探讨[J]. 医学临床研究, 2007, 24(6): 980-981.
22.	冯晴, 贺春花, 万琪, 等. 子宫动脉栓塞术在子宫肌瘤治疗中的应用进展[J]. 山东医药, 2011, 51(15): 109-110.
23.	Siskin GP. Uterine fibroid embolization complication[J]. J Vascul Int Radiol, 2000, 11(1): 38-40.
24.	Payne JF, Haney MD, Haney AF. Serious complications of uterine artery embolization for conservative treatment of fibroids[J]. Fertil Steril, 2003, 79(1): 128-131.
25.	徐阳, 傅文莉, 王华. 9例子宫肌瘤介入治疗并发症的分析及护理[J]. 中华护理杂志, 2007, 42(8): 709-710.
26.	Spies JB, Ascher SA, Roth AR, et al. Uterine artery embolization for leiomyomata[J]. Obstet Gynecol, 2001, 98(1): 29-34.

1. 　Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in caesarean section scars: the 8 year experience of one medical centre[J]. Hum Reprod, 2004, 19(2): 278-284.
2. 　Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
3. 　Elgersma O, van der Valk P, Maassen M, et al. Complications and failure of uterine artery embolisation for intractable postpartum haemorrhage[J]. BJOG, 2009, 116(9): 1277-1278.
4. 　Katsumori T, Kasahara T, Oda M, et al. Initial experience of uterine fibroid embolization using porous gelatin sponge particles[J]. Cardiovasc Intervent Radiol, 2011, 34(3): 513-521.
5. 　Smeets AJ, Nijenhuis RJ, van Rooij WJ, et al. Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 943-948.
6. 　Devine K, Stella M, Raja A. Case of the month. Cesarean scar ectopic pregnancy[J]. JAAPA, 2011, 24(7): 70.
7. 　Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
8. 　Kang SY, Park BJ, Kim YW, et al. Surgical management of cesarean scar ectopic pregnancy: hysterotomy by transvaginal approach[J]. Fertil Steril, 2011, 96(1): e25-e28.
9. 　Ash A, Smith A, Maxwell D. Caesarean scar pregnancy[J]. BJOG, 2007, 114(3): 253-263.
10. 　Maymon R, Svirsky R, Smorgick N, et al. Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy[J]. J Ultrasound Med, 2011, 30(9): 1179-1184.
11. 　Wang Y. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar[J]. BJOG, 2006, 113(9): 1035-1038.
12. 　Zhuang YL, Huang LL. Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar[J]. Am J Obstet Gynecol, 2009, 201(2): 152.e1-152.e3.
13. 　Lian F, Wang Y, Chen W, et al. Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern[J/OL]. Cardiovas Intervent Radiol, 2011[2011-07-20]http://www.springerlink.com/content/co486411or675378/fulltext.pdf.
14. 　Liang F, He J. Methotrexate based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy[J]. Acta Obstet Gynecol Scand, 2010, 89(12): 1592-1594.
15. 　Yang X. Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy[J]. BJOG, 2010, 117(8): 990-996.
16. 　Hirakawa M, Tajima T, Yoshimitsu K, et al. Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes[J]. Am J Roentgenol, 2009, 192(6): 1601-1607.
17. 　Sone M, Osuga K, Shimazu K, et al. Porous gelatin particles for uterine artery embolization: an experimental study of intra-arterial distribution, uterine necrosis, and inflammation in a porcine model[J]. Cardiovasc Intervent Radiol, 2010, 33(5): 1001-1008.
18. 　欧阳欣, 周新春, 康友根, 等. 子宫动脉栓塞治疗5例剖宫产后子宫切口妊娠[J]. 重庆医学, 2010, 39(17): 2366-2367.
19. 　Li C, Feng D, Jia C, et al. Transcatheter arterial chemoembolization versus systemic methotrexate for the management of cesarean scar pregnancy[J]. Int J Gynecol Obstet, 2011, 113(3): 178-182.
20. 　桑霞, 寿坚. 经子宫动脉栓塞术治疗剖宫产后子宫瘢痕妊娠[J]. 浙江预防医学, 2010, 22(5): 66-67.
21. 　廖红荔, 王维, 罗贤明, 等. 经子宫动脉介入治疗剖宫产瘢痕妊娠价值探讨[J]. 医学临床研究, 2007, 24(6): 980-981.
22. 　冯晴, 贺春花, 万琪, 等. 子宫动脉栓塞术在子宫肌瘤治疗中的应用进展[J]. 山东医药, 2011, 51(15): 109-110.
23. 　Siskin GP. Uterine fibroid embolization complication[J]. J Vascul Int Radiol, 2000, 11(1): 38-40.
24. 　Payne JF, Haney MD, Haney AF. Serious complications of uterine artery embolization for conservative treatment of fibroids[J]. Fertil Steril, 2003, 79(1): 128-131.
25. 　徐阳, 傅文莉, 王华. 9例子宫肌瘤介入治疗并发症的分析及护理[J]. 中华护理杂志, 2007, 42(8): 709-710.
26. 　Spies JB, Ascher SA, Roth AR, et al. Uterine artery embolization for leiomyomata[J]. Obstet Gynecol, 2001, 98(1): 29-34.

West China Medical Journal

子宫动脉化疗栓塞在子宫切口妊娠中的研究进展

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