经子宫动脉氨甲蝶呤灌注及栓塞 在宫颈妊娠保守治疗中的应用

目的探讨经子宫动脉氨甲蝶呤灌注化疗及栓塞术在宫颈妊娠保守治疗中的应用价值.方法 6例宫颈妊娠患者,孕龄36～68天,经阴道超声检查明确诊断后,行双侧子宫动脉氨甲蝶呤灌注及栓塞治疗.结果所有患者均一次治疗成功,术后患者的阴道出血明显减少或中止,血β-HCG水平迅速下降.患者的宫颈形态及月经周期于治疗后4个月内恢复正常.结论子宫动脉氨甲蝶呤灌注化疗及栓塞术是保守治疗宫颈妊娠的有效方法.

Methotrexate and uterine artery embolization for conservative treatment of cervical pregnancy

Objective To evaluate the value of methotrexate chemotherapy and uterine artery embolization in the treatment of cervical pregnancy. Methods We report our experience at Peking University People's hospital in which this technique was used in 6 cases within the past 5 years. All the cases were diagnosed with vaginal ultrasound and their gestational age at diagnosis ranged from 36 to 68 days. After admission, they were conservatively managed with intra-arterial methotrexate injection and selective embolization of bilateral uterine arteries. Results The cervical pregnancies were successfully ablated with one treatment in all cases. After the treatment, their vaginal bleeding ceased and the level of serum beta-human chorionic gonadotropin decreased rapidly. Resumption of normal menstrual cycles and a normal transvaginal ultrasonographic appearance of the cervical canal were documented within 4 months after the procedure. Conclusion Uterine artery chemotherapy and embolization is a safe and effective treatment for cervical pregnancy.