输卵管妊娠的介入治疗(附30例报告)

Interventional Therapy for Tubal Pregnancy(Report of 30 Cases)

目的 :探讨运用综合介入方法治疗输卵管妊娠的临床疗效。材料与方法 :对 30例未破裂输卵管妊娠患者 ,在电视透视下 ,将微导管选择性插入患侧输卵管内 ,造影摄片 ,了解输卵管妊娠的影像改变 ,再经微导管插入微导丝刺破胚囊后一次性缓慢注入 4 0mgMTX (氨甲蝶呤 )生理盐水溶液 10ml。其中 4例出血多者 ,并用Seldinger技术插管 ,选择性插入患侧子宫动脉内 ,一次灌注MTX ,药物灌注完毕后 ,用明胶海绵颗粒栓塞该动脉。结果 :30例一次插管治疗成功 ,血清绒毛膜促性腺素术后第 5天开始下降 ,2 1～ 2 8d降至正常水平 ,妊娠囊块 2～ 2 5个月吸收。结论 :介入导管治疗输卵管妊娠有很好的临床应用价值。

Purpose:To evaluate the efficacy of combined interventional therapies for the treatment of tubal pregnancy.Materials and Methods:30 cases of tubal pregnancy were studied.Under fluoroscopy guidance,use 3F catheter was introduced to the site of tubal gestation through the uterine cavity and radiography,the image to comprehend Fallopian tube pregnancy features,Stick in tiny guide wire and stabs damagedly embryo sac after tiny catheter again.Then methotrexate 40mg in 10ml saline was injected.In it 4 instances bleeding much,the treatment followed a procedure of first administering methotrexate (MTX) via the feeding uterine artery and then occluding it with a slurry of gelfoam.Results:On the 5th day after operation,the level of serum HCG began to decline reaching the normal value of the 21th～28th day.The gestation sac was absorbed after 2～2 5 months.Conclusion:Interventional therapy is a valuable and practical method for tubal pregnancy.