高强度聚焦超声消融术与子宫动脉栓塞术预处理剖宫产瘢痕妊娠临床疗效对比

Comparison of the Clinical Efficacy of High-Intensity Focused Ultrasound Ablation versus Uterine Artery Embolization for the Pretreatment of Cesarean Scar Pregnancy

摘要: 剖宫产瘢痕妊娠(CSP)是指妊娠过程中胚胎种植于子宫剖宫产瘢痕处的一种疾病，为异位妊娠的一种特殊类型，我国发病率逐年升高。如未及时诊治或错误诊治，可能导致不可控的子宫大出血、子宫破裂等并发症，必要时可能切除子宫，严重威胁患者生命及生活质量。早诊断后早治疗对其治疗有重要意义。CSP的治疗以手术治疗为主，但目前对最佳治疗方式尚无统一定论。高强度聚焦超声(HIFU)或子宫动脉栓塞术(UAE)在手术前预处理病灶可有效减少术中出血，改善预后。本文旨在对清宫术联合HIFU或UAE预处理治疗CSP的治疗效果进行综述。以期对临床治疗提供参考。

Abstract: Cesarean section scar pregnancy (CSP) refers to a disease in which the embryo is implanted in the uterine cesarean section scar during pregnancy, which is a special type of ectopic pregnancy, and the incidence rate in China is increasing year by year. If it is not diagnosed and treated in time or incorrectly, it may lead to uncontrollable complications such as uterine bleeding and uterine rupture, and the uterus may be removed if necessary, which seriously threatens the patient’s life and quality of life. Early diagnosis and accurate diagnosis are important for its treatment. Surgery is the main treatment for CSP, but there is no consensus on the best treatment modality. High-intensity focused ultrasound (HIFU) or uterine artery embolization (UAE) can effectively reduce intraoperative bleeding and improve prognosis by pretreating the lesion before surgery. The purpose of this article is to review the therapeutic effect of uterine evacuation combined with HIFU or UAE pretreatment in the treatment of CSP, in order to provide a reference for clinical treatment.