介入技术治疗输卵管妊娠临床体会

目的:探讨经子宫动脉途径治疗输卵管妊娠的可行性和临床疗效。方法:采用介入方法治疗32例输卵管妊娠患者。以4.1~5.0Fr导管行选择性子宫动脉内灌注MTX(氨甲喋呤)50mg,灌注后用明胶海绵栓塞子宫动脉。术后以患者症状、体征、β-HCG水平及孕囊B超值的动态变化作为疗效的监测指标。将MTX(氨甲喋呤)和米非司酮联合治疗病人设为对照组。结果:观察组较对照组能明显缩短血β-HCG(绒毛膜促性腺激素)降至正常范围的时间,减少住院日,提高治疗成功率(P<0.01)。介入治疗输卵管妊娠的成功率为96.88%,明显高于对照组。观察治疗期间病情变化,发现疗效与血β-HCG高低及有无心管搏动有关。结论:介入治疗输卵管妊娠疗效可靠,操作简便,尤其经动脉途径更有价值,介入治疗应成为终止输卵管妊娠的重要手段。

Clinical experience of treating tubal pregnancy patients by interventional treatment

Objective: To explore the feasibility and clinical effect of transuterinal artery interventional therapy for tubal pregnancy patients. Methods: We cured 32 cases of tubal pregnancy by interventional methods. In the procedure 4.1～5.0Fr catheters were used for performing superselective angiography in uterine artery and then infusing MTX(methotrexate) 50mg. Finally gelfoam particles or stripes were used to embolize uterine artery. After the treatment, conditions of the patients, β-HCG level and ultrasound changes of the gestational sac were the main indexes for monitoring the therapeutic effect in this study. The case with the combination of methotrexate and mifepristone were selected as control group. Results: The success rate of the interventional treatment for tubal pregnancy was 96.88%,which was significantly higher than that of the control group. Serum β-HCG levels was descent and hospitalization time was lessened,which improve treatment success rates. Conclusion: Interventional treatment for tubal pregnancy patients is effective, reliable and easy.