经动脉药物灌注栓塞治疗输卵管异位妊娠42例临床分析

42 cases of clinical study of treatment in tubal pregnancy by combination of embolization and infusion with methotrexate

目的:研究经动脉药物灌注栓塞治疗输卵管妊娠的疗效,输卵管解剖及卵巢功能变化。方法:对42例明确诊断输卵管妊娠的患者,行超选择子宫动脉造影后经导管注入MTX(氨甲喋呤)100mg或MTX100mg+5-Fu0.5g,用明胶海绵颗粒对子宫动脉行完全性栓塞。对其中15例未生育患者术前及术后3、6月分别测定其性激素水平,术后第3次月经后行子宫输卵管造影。结果:41例患者经治疗后2～3周孕囊缩小,血β-hCG(人绒毛膜促性腺激素)值下降至正常值(小于30mIU/ml),其中15例术后女性激素水平无变化,输卵管畅通,1例由于术前孕囊较大,术后第2天孕囊破裂,行手术治疗。结论:经子宫动脉化疗及栓塞是治疗输卵管妊娠的有效方法,可有效保留卵巢及输卵管的生理及解剖功能。

Objective：To investigate the effect of combination of embolization and infusion with MTX and 5-Fu on patients with tubal pregnancy, and to observe the changes of patients ovarian function and oviductal anatomical structure.Methods：42 patients suffering form oviduct pregnancy were went through infusion of MTX and 5-Fu through uterine artery and uterine artery embolized with granule-sponge of gelatin. In 15 patients without procreation, the level of sex hormone was examined before and 3, 6 months after the operation. And hysterosalpingography was performed 3 month after the operation. Results：2 to 3 weeks after operation, the gestation sac was shrank and the level of β-hCG was returned to normal in 41 patients. Tne level of sex hormone has no change and the oviduct was unobstructed in 15 patients. 1 patient was received surgical operation treatment the next day after interventional operation because of the rupture of gestation sac which is very large. Condusion：Tne combination of embolization and infusion with MTX and 5-Fu is good for patients with oviduct pregnancy, and the functions of ovary and oviduct are retained.