选择性输卵管造影诊断并介入治疗输卵管妊娠

The diagnosis and treatment of tubal pregnancy with selective salpingography

目的 探索用选择性输卵管造影方法诊断并介入治疗输卵管妊娠。方法 选临床拟诊宫外孕而无腹腔内出血的妇女 13例 ,用选择性输卵管造影方法明确为输卵管妊娠后 ,则向输卵管内注入氨甲喋呤 (MTX) ,以后随访尿、血绒毛膜促性腺激素 (hCG)和B超监测附件包块情况。结果 诊断输卵管妊娠 12例 ,宫内妊娠 1例。X线表现为输卵管腔局限性膨大 ,腔内见半环状、环状或不规则充盈缺损 11例 ,1例输卵管腔显影正常 ,但在输卵管伞端见对比剂呈葡萄串状集聚。 12例经输卵管内注射MTX治疗 ,10例获得成功。结论 选择性输卵管造影诊断并介入治疗输卵管妊娠是简便、准确、安全。

Objective To study feasibility of diagnosing and treating tubal pregnancy with selective salpingography Methods 13 women diagnosed clinically as ectopic pregnancy without abdominal bleeding were studied and confirmed as tubal pregnancy with selective salpingography, MTX was then injected through fallopian tube Urine hCG, blood β hCG and US were studied during follow up. Results 12 cases tubal pregnancy were confirmed as well as 1 case of intra uterine pregnancy X ray showed a localized dilation of fallopian tube , half loop, ring like or irregular shaped filling defect In one case, cluster of grapes appearance of contrast medium could be seen at the frimbriate end of fallopian tube. Of the 12 cases of tubal pregnancy, 10 were successfully treated, the successful rate was 83%. Conclusion Selective salpingography is a simple 、safe and effective method of diagnosing and treating tubal pregnancy