• 四川大學華西第二醫(yī)院婦產科（成都，610041）;

【摘要】　 剖宮產術后子宮切口妊娠（cesarean scar pregnancy，CSP）是指孕卵或胚囊著床于剖宮產術后子宮切口瘢痕處的一種少見而危險的異位妊娠，是剖宮產的遠期并發(fā)癥之一。若診治不當，有引起子宮破裂和無法控制陰道大出血的風險，危及患者生命。近年來，隨著微創(chuàng)介入治療技術的發(fā)展，子宮動脈栓塞術被廣泛用于CSP的治療，并且可聯(lián)合甲氨蝶呤動脈灌注，迅速有效止血，保留患者子宮和生育功能，為以后清宮治療提供了必要條件，安全有效?，F(xiàn)就子宮動脈化療栓塞在CSP中的研究進展闡述如下。

引用本文： 王飛,白莉平,褚艷俠,陳亞麗,鄭艾. 子宮動脈化療栓塞在子宮切口妊娠中的研究進展. 華西醫(yī)學, 2011, 26(12): 1909-1912. doi: 復制

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. 　歐陽欣, 周新春, 康友根, 等. 子宮動脈栓塞治療5例剖宮產后子宮切口妊娠[J]. 重慶醫(yī)學, 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, 壽堅. 經(jīng)子宮動脈栓塞術治療剖宮產后子宮瘢痕妊娠[J]. 浙江預防醫(yī)學, 2010, 22(5): 66-67.
21. 　廖紅荔, 王維, 羅賢明, 等. 經(jīng)子宮動脈介入治療剖宮產瘢痕妊娠價值探討[J]. 醫(yī)學臨床研究, 2007, 24(6): 980-981.
22. 　馮晴, 賀春花, 萬琪, 等. 子宮動脈栓塞術在子宮肌瘤治療中的應用進展[J]. 山東醫(yī)藥, 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. 　徐陽, 傅文莉, 王華. 9例子宮肌瘤介入治療并發(fā)癥的分析及護理[J]. 中華護理雜志, 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. 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. 2. 　Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
  3. 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. 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. 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. 6. 　Devine K, Stella M, Raja A. Case of the month. Cesarean scar ectopic pregnancy[J]. JAAPA, 2011, 24(7): 70.
  7. 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. 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. 9. 　Ash A, Smith A, Maxwell D. Caesarean scar pregnancy[J]. BJOG, 2007, 114(3): 253-263.
  10. 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. 11. 　Wang Y. Operative laparoscopy for unruptured ectopic pregnancy in a caesarean scar[J]. BJOG, 2006, 113(9): 1035-1038.
  12. 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. 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. 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. 15. 　Yang X. Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy[J]. BJOG, 2010, 117(8): 990-996.
  16. 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. 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. 18. 　歐陽欣, 周新春, 康友根, 等. 子宮動脈栓塞治療5例剖宮產后子宮切口妊娠[J]. 重慶醫(yī)學, 2010, 39(17): 2366-2367.
  19. 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. 20. 　桑霞, 壽堅. 經(jīng)子宮動脈栓塞術治療剖宮產后子宮瘢痕妊娠[J]. 浙江預防醫(yī)學, 2010, 22(5): 66-67.
  21. 21. 　廖紅荔, 王維, 羅賢明, 等. 經(jīng)子宮動脈介入治療剖宮產瘢痕妊娠價值探討[J]. 醫(yī)學臨床研究, 2007, 24(6): 980-981.
  22. 22. 　馮晴, 賀春花, 萬琪, 等. 子宮動脈栓塞術在子宮肌瘤治療中的應用進展[J]. 山東醫(yī)藥, 2011, 51(15): 109-110.
  23. 23. 　Siskin GP. Uterine fibroid embolization complication[J]. J Vascul Int Radiol, 2000, 11(1): 38-40.
  24. 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. 25. 　徐陽, 傅文莉, 王華. 9例子宮肌瘤介入治療并發(fā)癥的分析及護理[J]. 中華護理雜志, 2007, 42(8): 709-710.
  26. 26. 　Spies JB, Ascher SA, Roth AR, et al. Uterine artery embolization for leiomyomata[J]. Obstet Gynecol, 2001, 98(1): 29-34.