超声引导下穿刺治疗未破裂型输卵管妊娠36例疗效观察

目的观察经阴道超声引导下穿刺注射甲氨蝶呤治疗未破裂型输卵管妊娠的临床效果。方法将临沂市河东区妇幼保健院2007年11月至2011年11月收治的66例确诊的未破裂型输卵管妊娠患者随机分为两组,A组(36例)在超声引导下穿刺治疗,向输卵管妊娠部位注入甲氨蝶呤50 mg;B组(30例)采用单次肌内注射甲氨蝶呤50 mg。比较两组患者的临床疗效、治疗1周后包块大小、血β绒毛膜促性腺激素(β-HCG)水平下降至正常的时间、患者住院时间、输卵管通畅率、月经复潮时间及不良反应等情况。结果两种治疗方法的疗效、治疗1周后包块大小、β-HCG水平下降至正常的时间、患者住院时间、输卵管通畅率比较差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异有统计学意义(P<0.05)。结论超声引导下穿刺治疗和肌内注射治疗未破裂型输卵管妊娠均能获得良好的疗效。前者的疗效更佳,能更好地保留输卵管,缩短患者的住院时间。

Observation on the Therapeutic Effect for 36 Patients Treated for Unruptured Early Tubal Pregnancy by Centesis Inducted with Ultrasonography

Objective To observe the effect of transvaginal ultrasound guided injection of methotrexate in the treatment of unruptured tubal pregnancy.Methods 66 cases confirmed unruptured tubal pregnancy in Maternal and Child Care Center of Hedong District in Linyi City from Nov.2007 to Nov.2011 were randomly divided into two groups,36 cases in group A adopted treatment of ultrasound guided puncture,injection methotrexate 50 mg to tubal pregnancy,30 cases in group B adopted single intramuscular injection 50 mg methotrexate.The therapeutic effect,the package size 1 week after treatment,the time of serum βchorionic gonadotropin(β-HCG)level dropping to the normal,the hospitalization time,the tubal patency rate and return of menses time of group A and B group were compared,and the adverse reaction of the two groups were observed.Results The curative effects,the package size 1 week after treatment,the time of β-HCG level dropping to the normal,the hospitalization time,the tubal patency rate of two treatment methods had significant difference(P<0.05).The difference between the two groups of adverse events was statistically significant(P<0.05).Conclusion The ultrasound guided puncture treatment and intramuscular injection to unruptured tubal pregnancy both had good effect,while the former method had better effect with better retained oviduct and shortened hospitalization time.