超声引导下经阴道细针穿刺注射5-FU治疗宫外孕的疗效观察

Clinical Study of Transvaginal Ultrasound-guided Fine-needle Injection of 5-FU Treatment for Ectopic Pregnancy Efficacy

目的:探讨超声引导下经阴道应用细针穿刺注射5-FU介入治疗异位妊娠的临床疗效。方法:超声引导下经阴道用18G及22GPTC针对42例未破裂型异位妊娠病灶进行穿刺抽吸囊液后,注射5-氟尿嘧啶(5-FU)及氨甲喋呤(MTX)治疗,进行疗效观察。结果:应用22G细针穿刺,一次性穿刺成功病例21例,成功率100%;穿刺出血病例3例,穿刺后出血发生率14.2%。对照组18G粗针穿刺,分别为15例、71.4%;9例、42.8%;差异具有显著性(P<0.05)。注射5-FU术1周病人血HCG测量值及异位妊娠病灶缩小或消失率达到90.4%、治疗方法有效率为95.2%,对照组注射MTX分别为71.4%、80.9%;差异具有显著性(P<0.05)。结论:超声引导下经阴道22G细针穿刺注射5-FU治疗未破裂型宫外孕较18G粗针及注射MIX疗效显著,成功率高、副反应少,为临床保守治疗未破裂型异位妊娠穿刺针型号及用药种类的选择提供了一种新的方法,有一定的临床应用价值。

Objective： To investigate the clinical efficacy of transvaginal ultrasound-guided fine-needle injection of the application of 5-FU intervention in the treatment of ectopic pregnancy. Methods： 42 cases of unruptured ectopic pregnancy were treated by transvagi- nal ultrasound-guided 22 G and 18 G PTC lesion aspiration for cystic fluid, and then the injection of 5-fluorouracil （5-FU） and methotrexate （MTX）. Results： 21 cases in the 22G fine-needle aspiration group successed in one-time punctureing, and the successful rate is 100%; 3 cases out of them（14.2% ） were bleeding. In the control group that were treated with the 18G needle, 15 cases （71.4%） were successful, and 9 cases （42.8%） were bleeding. Difference between the two group was significant （P〈0.05）. HCG measurements or disappearance of lesions one week after injection of 5-FU in blood of patients showed the reduction rate of ectopic pregnancy reached 90.4%, and the treatment efficiency was 95.2, while that of the control group which was treated with MTX injection was 71.4% and 80.9% respectively; the difference was significant （P〈0.05）. Conclusions： Clinical efficacy of transvaginal ultrasound-guided fine-needle aspiration 22G with injection of 5-FU treatment of unruptured ectopic pregnancy was better than 18G with injection MIX for its high success rate and few side effects. It provides a valuable approach for clinical application.