超声引导下氨甲蝶呤局部注射治疗输卵管间质部妊娠

目的 探讨超声引导下局部注射氨甲蝶呤(MTX)治疗输卵管间质部妊娠(TIP)的价值.资料与方法 回顾性分析2005-06～2009-10在解放军总医院超声诊断科接受超声引导下局部注射MTX治疗的9例TIP患者的临床资料和治疗前后声像图特点,记录血清人绒毛膜促性腺激素(β-HCG)恢复正常的时间和超声随访结果.结果 9例接受治疗的患者停经时间均≤60d.治疗成功的8例均可在超声下清晰显示妊娠病灶边界,且治疗前血清β-HCG≤50 000U/L,其中6例为孕囊型,最大径≤2.5cm,2例为包块型,最大径分别为2.6cm和3.5cm,血清β-HCG恢复至正常值的时间为14～63d.治疗失败的1例孕囊最大径为3.8cm,血清β-HCG＞50 000U/L.结论 超声引导下局部注射MTX治疗早期未破裂型TIP是一种安全有效的方法,对停经60d以内、孕囊最大径≤2.5cm且边界显示清晰、血清β-HCG≤50 000U/L的患者治疗成功率高.

Ultrasound-guided Methotrexate Local Injection Treatment of Tube Interstitial Pregnancy

Purpose To explore the value of ultrasound-guided methotrexate local injection treatment of tube interstitial pregnancy.Materials and Methods The ultrasonography and clinical data of 9 patients with TIP who were treated in our department from June 2005 to October 2009 were analyzed.Time interval between treatment and complete β-HCG resolution as well as ultrasound follow-up were recorded.Results In 9 cases undergoing ultrasound-guided methotrexate local injection treatment,8 were successfully treated.The lesions were clearly shown on ultrasound and the serum β-HCG level were under 50 000U/L.In 6 out of the 8 successful cases,the gestational sac diameter was ≤2.5 cm;the other 2 had the gestational sacs of 2.6 cm and 3.5 cm.Complete β-HCG resolution was achieved in 14-63 days.The maximum diameter of gestation sac in the failed case was 3.8cm and the pretreatment serum β-HCG level was > 50 000U/L.Conclusion Ultrasound-guided methotrexate local injection treatment is safe and effective for early un-ruptured interstitial pregnancy with gestational age < 60 days,the maximum length of gestational sac ≤2.5 cm,and the serum β-HCG level is ≤50 000U/L.