宫腔镜插管注入氨甲蝶呤配合中药治疗输卵管妊娠临床研究

Clinical research of amethopterin is infused into oviduct under hysteroscope intubation act in connect with traditional herb to cure salpingocyesis

目的利用宫腔镜下输卵管插管注入氨甲蝶呤配合中药对输卵管妊娠进行治疗。方法200例输卵管妊娠患者,在宫腔镜下将导管插入患侧输卵管口,注入氨甲蝶呤60mg,同时服用中药治疗,B超观察妊娠囊内胚芽、原始心搏消失情况以及血β-HCG下降情况。结果190例包块直径<5cm,β-HCG值在10.6￣34.7μg/L,孕龄在36￣56d患者,经治疗后10￣16dβ-HCG下降至正常,B超示2d后胚芽及原始心搏消失,1、2个月包块吸收。10例患者,孕龄平均60d,包块直径>5cm,β-HCG值在45.0￣86.5μg/L,用药后腹痛加剧2例,β-HCG持续不下降,包块增大8例,均行腹腔镜手术治疗。结论宫腔镜下输卵管插管注入氨甲蝶呤配以中药治疗,对孕周小、β-HCG值低、包块直径<5cm的输卵管妊娠患者治疗有效。

[Objective] Amethopterin is infused into oviduct under hysteroscope intubation act in connect with traditional herb to cure salpingocyesis. [Methods] To put conduction tube into ostium uterinum tubae under hysteroscope to cure 200 cases of salpingocyesis. Infuse amethopterin 60 mg into oviduct, meanwhile cure with traditional herb. To observe the cases of blastulas cardiac impulses die away and the β-HCGs descend. [Rusults] 190 cases in which the diameters of enclosed mass are 5 cm. β-HCG： from 10.6 to 34.7 ug/Ls, gestations from 36 to 56 days, after treatment of the β-HCGs fal/down to normals, blastulas and cardiac impulses die away under β-HCG examination, enclosed masses disppear. 10 cases whose average gestations are 60 days, the diameters of enclosed masses are 〉5 cms, -HCG： from 45.0 to 86.5 ug/Ls. 2 cases abdominalgia is exacerbations after cure with traditional herbs. β-HCG has not fallen down. 8 cases enclosed masses is enlarged. All of these cases are cured with operations under celioscope. [Conclusions] Amethopterin infusion act in connect with traditional herb under hysteroscope intubation and cure with traditional herb are effective for those salpingocyesiss cases in which the conception are shorter. β-HCGs are minimals, diameters of enclosed massers are 〈5 cm.