超声介入治疗未破裂型输卵管妊娠的临床研究

目的研究超声引导下穿刺孕囊注入氨甲蝶呤治疗未破裂型输卵管妊娠的临床价值。方法采用经腹或经阴道超声引导和实时监视下用19G PTC针对18例未破裂型输卵管妊娠的孕囊进行穿刺,抽尽囊液,并注入氨甲蝶呤（MTX）20～40 mg,治疗后3 d、1周、半月、1个月、2个月复查超声检查和血β-HCG。结果治疗18例,治愈17例,1例在介入治疗随访过程中发生破裂改用腹腔镜手术治疗,介入治疗治愈率94.4%。结论超声引导下穿刺注入氨甲蝶呤治疗未破裂型输卵管妊娠具有操作简单、安全高效、创伤小、费用低等优点,可作为治疗未破裂型输卵管妊娠首选方法,尤其适用于渴望保留生育功能或已做过异位妊娠手术的患者。

Clinic Research of Treatment of Unruptured Tubul Preghang with Ultrasound Intervention

Objective To explore the clinic value of treatment Unraptured Tubal preghany by puncturing and injecting MTX to gestational sac under ultrasond-guided.Methods Under Transabdominal or transvaginal ultrasound guided and real-time monitored,eighteen cases received the treatment by injecting 20-40 mg MTX inside the gestational sac after aspirating fluid with 19G PTC needle,ultrasonography and blood β-HCG were reviewed on third day,one week half month,one month and two months after treatment.Results Eighteen patients received the treatment and seventeen cases were cured,the interventional therapy cure rate was 94.4%,only one case was treated failure in follow-up time and switched to the laparoscopic operation.Conclusion This method of treatment had advantage of simplicity,safety,high efficacy,small trauma and low cost,which can be the first choice method to treat the Unruptured Tubul preghang,especially can be applied to the patients who hope to preserve fertility or had done ectopic pregnancy surgery.