生殖医学杂志

目的探讨子宫动脉化疗栓塞术(UACE)治疗剖宫产瘢痕妊娠(CSP)对患者卵巢功能的影响。方法选取2014年7月至2015年7月在我院计划生育科诊断为CSP并行UACE+刮宫术住院的患者共100例为研究对象,分别于术前及术后第1、3、6、12个月的月经周期第2⁵天抽静脉血检查血清卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E2)、抗苗勒管激素(AMH)、抑制素B(INHB)水平,并随访月经情况及围绝经期症状。观察术前及术后不同时期的激素水平变化及月经变化。结果所有病例均成功清除瘢痕妊娠组织,均未出现围绝经期症状。72例(73.5%)在术后1³个月月经复潮,经量正常,周期规律;16例(16.3%)术后4⁶月月经来潮,规律,量正常;10例(10.2%)术后12个月内恢复月经,但曾出现过月经紊乱。术前与术后各时段血清FSH、LH、E₂、AMH、INHB水平比较均无显著性差异(P>0.05)。结论在具备准确熟练的手术操作技术基础上,UACE治疗对CSP患者卵巢内分泌功能及储备功能均无明显影响,是一种安全、有效的治疗方法。

Objective:To investigate the effect of uterine artery chemoembolization(UACE)on ovarian function in patients with cesarean scar pregnancy(CSP).Methods:One hundred patients with cesarean scar pregnancy treated by UACE and curettage in Beijing Obstetrics and Gynecology Hospital from July 2014 to July 2015 were included as subjects.The levels of sex hormones(FSH,LH,E2,AMH,INHB)before and after UACE were detected.The menstruation symptoms were observed.Results:The scar pregnancy tissues were successfully removed in all patients,and the patients did not appear perimenopausal symptoms.The menstruation of 72 patients(73.5%)was returned to regular and normal menstrual flow 1 to 3 months after UACE and 16 patients'(16.3%)after 4 to 6 months.Ten patients(10.2%)recovered menstruation within 12 months after the operation,but there had menstrual disorder.There were no significant differences in the levels of FSH,LH,E₂,AMH,INHB before and after UACE(P>0.05).Conclusions: On the basis of accurate and skilled operation technique,uterine arterial chemoembolization has no obvious effect on ovarian endocrine function and reserve function in patients with cesarean scar pregnancy.It is a safe and effective treatment technique.