经阴道超声对异位妊娠单剂量氨甲喋呤治疗结果的预测价值

Predictive value of transvaginal sonography for systemic methotrexate treatment of unruptured ectopic pregnancy

目的研究经阴道超声对异位妊娠氨甲蝶呤(MTX)治疗结果的预测价值。方法回顾性总结106例经MTX治疗的异位妊娠患者的经阴道超声声像图表现。结果异位妊娠囊内探及胎心及卵黄囊者均治疗失败。异位妊娠包块小于1.5cm的病例均治疗成功。治疗成功组和治疗失败组在1.5cm以上包块大小、包块表现形式、盆腔积液、低阻动脉血流的存在等方面的差异均无显著性意义。结论经阴道超声二维声像图表现对预测异位妊娠MTX治疗结果有一定价值,彩色多普勒血流成像的预测价值尚需进一步研究。

Objective To evaluate the predictive efficiency of transvaginal sonography for the systemic methotrexate treatment of unruptured ectopic pregnancy. Methods A retrospective study of transvaginal sonography findings of 106 patients diagnosed as ectopic pregnancy and treated with intramuscular methotrexate. Results The treatment failed in all the cases with fetal heart or yolk sac, and succeeded in the cases with an adnexal mass less than 1.5 cm in size on transvaginal ultrasonography. There is no significant difference between the success and the failure group in the following aspects： thickness of the endometrium, feature of the adnexal mass, existence of free fluid in peritoneal cavity, existence of low resistance artery flow in/around the adnexal mass. Conclusion The grey scale transvaginal sonography can give some valuable information to predict the outcome of systemic methotrexate treatment of unruptured ectopic pregnancy. Further research is needed to evaluate the significance of color Doppler flow imaging of transvaginal sonography in this area.