输卵管妊娠的介入治疗

目的探讨输卵管妊娠介入治疗的可行性和临床价值。方法采用患侧子宫动脉灌注氨甲喋呤（MTX）和5-FU并用明胶海绵栓塞治疗58例输卵管妊娠患者。术后检测血清绒毛膜促性腺激素（β-HCG）和B超观察宫旁包块。结果输卵管妊娠治疗成功55例（94.68%）,3例无效（5.32%）改行外科手术。治愈者临床症状迅速消失,血清β-HCG水平从治疗后2d开始下降,降至正常时间平均为15.5d;B超观察孕囊包块在术后21-105d完全吸收;术后26-42d月经恢复正常。无效者术后观察至5-7d血清β-HCG仍未下降或呈上升趋势。治愈组和无效组均可出现阴道少量出血及轻度恶心或呕吐者,两者无显著差异。结论介入治疗输卵管妊娠安全、有效,并可以预防和减少破裂大出血。

Intervantional therapy of salpingocyesis

Objective To study the feasibility and clinical value of interventional therapy for treating tubal pregnancy.Methods Fifty-eight patients with tubal pregnancy were included into the study.In most cases,first administering methotrexete（MTX） and 5-FU via the feeding uterine artery were used and then occluding it with gelfoam.Blood β-HCG was analyzed parauterine mass was monitored ater operation.Results Fifty-five patients（94.68%） terminated pregnancy successfully and 3 patients（5.32%）failed and had to resort to surgery.The successfully treated patients manifested as gradully reduced bloodβ-HCG,absorbed adnex mass under ultrasonography,recoverd menstrual cycle and improved symptoms.Treatment failure had no reduced blood β-HCG or increased blood β-HCG.Conclution The interventional therapy is safe,effective and valuable for interrupting tubal pregnancy.It can prevent and decrease fatal bleeding by gestational sac rupture.