子宫动脉栓塞术治疗输卵管妊娠68例分析

Clinical analysis of 68 cases of the therapy of uterine arterial embolization to fallopianpregnancy

目的探讨子宫动脉栓塞术治疗输卵管妊娠的可行性。方法选择浙江萧山医院2006年4月至2009年1月β-HCG≥3000IU/L的年轻且未育的输卵管妊娠患者68例,在DSA下采用Seldinger’s技术将5-Fcobra-2导管结合3F-SP微导管插入患侧子宫动脉或上行支后灌注甲氨蝶呤(MTX)50～100mg后行明胶海绵栓塞。结果(1)插管成功率100%。(2)临床有效率98.5%,1例失败,改行腹腔镜手术治疗。(3)术后监测血β-HCG、孕酮(P)、盆腔包块的变化情况:β-HCG、P呈进行性下降。病灶包块绝大多数在3个月缩小到1cm或消失。(4)随访47例有生育要求者,目前已有21例妊娠,其中9例已正常分娩,3例自然流产,2例难免流产,7例正在妊娠中。结论子宫动脉灌注栓塞术治疗输卵管妊娠是一种保守、安全、有效、微创的方法。

Objective To discuss the feasibility of perfusion of the uterine artery embolization for tubal pregnant treatment. Method Choose 68 cases of β - HCG ≥ 3000IU/L and never bearing early unruptured tubal pregnant women, and then bend 5 - F catheter with 3F - SP - uterine artery catheterization or upstream side of reperfusion after MTX 50 gelatin sponge - 100rag after embolization by using Seldinger＇s technology under the DSA. Results The result was that the successful rate of intubation was 100% with 98.5% o And the only one failure case was diverted to treatment of laparoscopic surgery. We monitored the patient＇s blood β - HCG and P＇s changing afte operation. We found β - HCG and P show a decrease. After three month,the pelvic mass reduced to lcm. In the 47 random cases of patients who want have a baby,there were 21 case pregnancy, of which nine cases had normal delivery,of which three cases had natural abortion,of which two case had inevitable aboration. Conclusion The reperfusion of uterine artery embolization for the tubal pregnant treatment is safe, minimally invasive and effective.