双侧子宫动脉甲氨蝶呤灌注联合明胶海绵颗粒栓塞治疗子宫异位妊娠的临床研究

Clinical study on the treatment of ectopic pregnancy by methotrexate and the particle of gelatin sponge with uterine arteryembolization

目的探讨甲氨蝶呤（MTX）联合明胶海绵颗粒介入治疗子宫异位妊娠的临床应用价值。方法对48例异位妊娠患者行股动脉穿刺双侧子宫动脉甲氨蝶呤灌注联合明胶海绵颗粒栓塞治疗，观察其临床疗效。结果48例患者子宫动脉均栓塞成功，成功治愈异位妊娠44例（92％），其中输卵管妊娠38例全部成功治愈，非输卵管妊娠患者10例，仅6例介入治疗成功，输卵管妊娠患者介入治疗效果优于非输卵管异位妊娠患者（x2=16．582，P〈0．01）。术后30例患者出现腹痛；16例患者出现恶心、呕吐；9例患者出现低热，且无严重并发症。38例输卵管妊娠患者治愈成功后，术后3个月行输卵管造影检查，29例显示双侧输卵管通畅。结论甲氨蝶呤（MTX）联合明胶海绵颗粒介入治疗异位妊娠效果好，治疗输卵管妊娠效果优于非输卵管妊娠，且输卵管通畅率高。此法具有能高效杀死胚胎、迅速止血、创伤小等优点，且安全可靠，值得推广。

Objective To investigate the clinical application value of methotrexate and the particle of gelatin sponge treat ec- topic Pregnancy. Methods A total of 48 cases of ectopie pregnancy was analyzed retrospectively. Methotrexate and gelatin sponge particles were injected into the uterine artery embolization for the method of intervention, and its clinical application value was evalua- ted. Results All 48 patients were embolized uterine artery successfully. It treated successfully eetopie pregnancy 44 eases （92%）, including 38 eases of tubal pregnancy and other parts of the 6 cases. All patients were detected in 13-human chorionic gonadotropin （ [3- HCG） until normal about 3 weeks. No serious postoperative complications were found, only 30 patients with abdominal pain, 16 eases of patients with nausea and vomiting, 9 patients with low-grade fever were found. After four months, 29 patients were recanalizated successfully. Conclusions Treatment of ectopie pregnancy can kill embryos efficiently, stanch the bleeding rapidly, and have small operation wound. It is safe and reliable method and is worth populating.