经阴道多普勒超声引导下介入治疗输卵管妊娠

目的　探讨经阴道彩色多普勒超声 (TVS -CD)技术及非血管途径的介入对输卵管妊娠的诊断及治疗价值。方法　运用TVS -CD影像诊断输卵管妊娠未破裂型、流产型 ,并行相关专科扫查 ,在当天或次日行血β -hCG检查确诊后行输卵管介入治疗。经选择性输卵管插管于妊娠处注入氨甲喋呤 ,以终止妊娠。 结果　 4 7例中有 4 6例第一次超声扫查即做出了准确诊断 ,准确率达 97 6 % ,其中 1例停经 32天 ,因孕周介于“妊娠盲区”[1 ] ,尿 -hCG ( ) ,于 5天后第 2次复查超声方明确诊断。彩色血流检出率为 10 0 %。经上述输卵管途径介入治疗均获成功 ,治愈率 10 0 %。结论　采用经TVS -CD是早期准确诊断输卵管妊娠最有价值的首选方法 ,在此技术背景下 ,行经输卵管途径的介入治疗既能达到终止输卵管妊娠的目的 ,又能使输卵管的结构及完整性得以保护 ,不失为一种既能诊断 ,又能治疗的全新优势技术

Treatment of tubal pregnancy by transvaginal Doppler ultrasonic guide intervention.

Objective To probe the evaluation of transvaginal ultrasound color Doppler imaging(TVS-CD) and intervention in the diagnosis and treatment of tubal pregnancy cases.Methods Definite unrupture tubal pregnancy and abortion tubal pregnancy cases diagnosed by TVS-CD were identificated and certificated by blood examination or p-HCG.The definite tubal pregnancy cases were injected with methotrexate at the tubal pregnancy area,in order to stop the pregnancies.Results 47 cases were tubal pregnancy,46 cases were identificated at the first examination of TVS-CD,the accurate judgement rate was 97.6%,and 1 case was definited at the fifth day because the case was in pregnancy blind area and her urine-HCG was positive.The positive rates of color Doppler flow imaging in 47 cases were 100%,both the accurate diagnosing rate and the curing rate.Conclusions TVS-CD is the most important technique in the diagnosis of early tubal pregnancy.The diagnosis and treatment of tubal pregnancy with the combination of TVS-CD and tubal intervention is a sensitive and effective technique.