未破裂型输卵管妊娠超声引导下注射氨甲蝶呤治疗的价值

Therapeutic Value of Unrupture Tubal Pregnancy by MTX Inject Under Ultrasonic Guide

目的 探讨超声引导下经阴道侧穹窿注射氨甲蝶呤治疗未破裂型输卵管妊娠的价值。方法 对 30例未破裂型输卵管妊娠进行超声引导下经阴道侧穹窿胚囊内或胚囊周围穿刺注射氨甲蝶呤 (Methotrexate ,MTX) 2 0～35mg ,杀胚治疗。结果 超声引导下未破裂型输卵管妊娠肿块穿刺注射药物准确率 10 0 % ,胚囊大小 7 5±5 38mm ,胚囊内注射成功率 40 % ,胚囊周围注射成功率 6 0 % ;总治疗成功率 96 7%。注射MTX后 ,超声表现为胚囊变形、缩小、最后消失 ,胚囊周围滋养层血流显著减少、直至消失 ,约 3～ 6周后宫外孕肿块消失。结论 超声引导下经阴道侧穹窿穿刺注射氨甲蝶呤治疗输卵管妊娠 ,操作较简便 ,损伤较小 ,局部给药浓度高 ,疗效较好 ,疗程较短 ,有一定的临床价值。

Objective To explore the value of treatment for the unrupture type of tubal pregnancy by injecting MTX transvaginal side vault ultrason-guided. Methods Thirty cases received the embryo killing treatment by injecting 20～35mg MTX inside or outside of the gestation sac through puncturing vaginal side vault under ultrasonic guide. Results The accuracy rate of MTX inject into the tubal pregnancy was 100%. The lump average size was 7 5±5 38mm. The successful rate of inside gestation sac injection was 40% and around of gestation sac was 60%. The total successful rate was 96 7%. Gestation sac appeared gradually deformed, minified and finally disappeared. The blood flow of plasmodiblast gestation sac was reduced and the 1ump disappeared within 3 to 6 weeks. Conclusion This method of treatant offers high drug concentration in local region, good effect and shorter treatment course. [