介入手术治疗输卵管妊娠的临床应用研究

目的探讨经双侧子宫动脉灌注氨甲蝶呤化疗及介入栓塞术治疗输卵管妊娠的临床应用。方法采用Seldinger技术,对18例输卵管妊娠患者行双侧子宫动脉造影,氨甲蝶呤灌注及栓塞,术后以定期监测血β-HCG水平变化和超声检查作为治疗效果的评价手段。结果 18例患者均一次性介入治疗成功17例,术后一周复查超声见胚胎缩小,患者阴道出血明显减少或中止,血清β-HCG水平明显下降,月经周期于治疗后的2月恢复正常,4月后行子宫输卵管碘油造影,15例通畅,通畅率为83.3。结论介入治疗输卵管妊娠能有效的保存适龄患者的生育能力,是保守治疗输卵管妊娠的有效方法。

Interventional operations for treating fallopian tubal pregnancy

Objective：To study the application of the treatment of tubule pregnancy in clinic by perfusion of methotrexate（MTX） and embolization of both sides of the uterine artery with interventional technique.Methods：By using Seldinger＇s method,18 cases of tubule pregnancy received angiography of both sides of the uterine artery,followed by perfusion of methotrexate（MTX） and embolization of uterine artery.The concentration of serum β-HCG was regularly monitored postoperatively,and the technique of ultrasound was used as an index of the effect of treating.Results：All of the 18 cases were succeeded at one time.A week after treatment,embryo in the reexamination of ultrasound could be seen minimized.The bleeding in the vagina of the cases apparently reduced or ceased apparently,and the mean time that the serum β-HCG concentration shrunk obviously,and the mean time that catamenia cycle returned to normal two months after the therapy.Four months later in the case of who hoped their fertility remaining intact,the oviduct were verified open by hysterosalpingography（HSG） in 15 cases,the open rate was 83.3%.Conclusion：The treatment of tubule pregnancy by interventional technique was proved effective to preserve fertility.This method might be an effective way to the conservative therapy of tubal pregnancy.