标题：腹腔镜子宫动脉阻断术在子宫瘢痕妊娠手术中的应用

      作者：陈 滢，王 晶，童 明
    （广州军区武汉总医院妇产科，湖北 武汉 430070）

      卷次： 2013年24卷11期

      【摘要】 目的 探讨腹腔镜下子宫动脉阻断在处理子宫瘢痕部位妊娠手术中的应用价值。方法 回顾性
分析2007年1月至2011年11月在广州军区武汉总医院妇产科就诊的93例剖宫产术后子宫瘢痕妊娠患者，其中
A组23例行B超监测下清宫术；B组49例行双侧子宫动脉栓塞术，术后24 h行清宫术；C组21例先行腹腔镜子宫
动脉阻断术后行子宫瘢痕部位妊娠病灶清除术。结果 A组5例因术中大出血急诊行髂内动脉栓塞术；B组1例
患者因双侧子宫动脉栓塞术后清宫术中子宫瘢痕部位穿孔行修补术；C组均在腹腔镜下完成手术，无一例中
转开腹。比较三组患者术中平均出血量、手术并发症及平均住院日，C组患者均低于A、B组患者，差异具有统
计学意义，且其治疗费用虽高于A组，但明显低于B组患者。三组患者月经复潮时间相比差异无统计学意
义。结论 腹腔镜子宫动脉阻断术在处理子宫瘢痕部位妊娠手术中具有疗效确切、手术创伤小、相比较介入治
疗手术费用较低等优点，是治疗子宫瘢痕妊娠的较理想方法。

      【关键词】 腹腔镜；子宫动脉阻断；子宫疤痕妊娠

      【中图分类号】 R714.22 【文献标识码】 A 【文章编号】 1003—6350（2013）11—1599—03


Application of laparoscopic uterine arteries ligation in cesarean-scar pregnancy.
CHEN Ying, WANG Jing, TONG
Ming. Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan
430070, Hubei, CHINA

【Abstract】 Objective To investigate the feasibility, safety and the value of laparoscopic uterine arteries liga-
tion in cesarean-scar pregnancy (CSP). Methods Ninety-three patients of CSP which were treated in our hospital
from Jan. 2007 to Nov. 2011 were divided into three groups: group A, group B and group C. Patients in group A (n=
23) were treated with complete curettage of uterine cavity, patients in group B (n=49) accepted bilateral uterine artery
embolization, and patients in group C (n=21) were treated by laparoscopy in our department. During the opera-
tion, the uterine arteries were separated and ligated by laparoscopy and then the entire lesion was wedge resected.
Results Five patients in group A were converted for bilateral hypogastric artery embolization because of hemor-
rhage. One patient in group B was treated with uterine neoplasty for perforation of uterine. The procedure was suc-
cessfully completed without surgical complications or conversion to open surgery in all the cases of group C. Com-
pared with group A and B, the average intraoperative blood loss, post operative complications and hospital stay in
group C were significantly less. The hospital costs in group C were higher than group A but much cheaper than group
B. There was no statistically significant difference in the return of menstruation among the patients in the three groups.
Conclusion With advantages in minimal invasion and satisfactory effect, laparoscopic uterine arteries ligation can
be a better choice for the treatment of CSP.

      【Key words】 Laparoscopy; Uterine arteries ligation; Cesarean-scar pregnancy