经子宫动脉介入治疗非常见部位异位妊娠的应用探讨

Clinical evaluation of interventional therapy through uterine artery for ectopic pregnancy of unusual sites

目的:探讨放射性血管性介入治疗非常见部位异位妊娠的临床意义。方法:选择2008年5月～2009年5月非常见部位异位妊娠患者8例,回顾性分析异位妊娠发生部位、胚胎活性、手术方法、治疗前后的血HCG水平及其降至正常的时间,并对术后3～6月子宫输卵管碘油造影(HSG)及术后2年内再次妊娠情况进行综合分析。结果:8例中5例成功治愈,其中2例剖宫产疤痕切口妊娠,1例宫颈妊娠,2例宫角妊娠,3例开腹手术中2例为介入治疗失败,1例因放弃观察而开腹手术。2年内共有3例再次妊娠。结论:放射性血管性介入治疗是微创、低麻醉风险、高疗效的治疗技术,可有效保留患者生育功能,应用于宫颈妊娠、宫角妊娠和剖宫产疤痕切口妊娠等非常见部位异位妊娠的治疗具有其他方法无可比拟的优势。

Objective：To study the method of radioactive interventional therapy through uterine artery for ectopic pregnancy of unusual sites,assess its clinical effects and applicability.Methods：Some situation of 8 cases with ectopic pregnancy of unusual sites were analyzed,including the sites,embryo activities,methods of surgery,levels of HCG in blood just before and after surgery,the time of HCG dropping to normal level,the hysterosalpingogram after surgery 3 to 6 months and the gestation in the next 2 years.Results：In 8 cases with refractory ectopicpregnancy,5 cases were successfully cured,with 2 cases of cesarean scar pregnancy,1 case of cervix pregnancy and 2 cases of intramural pregnancy.The remaining 3 cases were performed exploratory laparotomy,with 2 cases of failed intervention and 1 case giving up expectant treatment to ask for laparotomy.There were 3 cases subsequent gestation in 2 years.Conclusion：The radioactive interventional therapy through uterine artery is a minimally invasive,with low anaesthetic risk and highly effective method of treating ectopic pregnancy of unusual sites,such as cervix,cornual pregnancy,intramural and cesarean scar pregnancies,especially in aspect of reserving the patients＇procreation functions.