经子宫动脉化疗栓塞治疗异位妊娠35例观察

Transcatheter uterine arterial chemoembolization for the treatment of ectopic pregnancy:report of 35 cases

目的探讨经子宫动脉化疗栓塞治疗异位妊娠的临床效果.方法对35例异位妊娠患者利用标准的动脉造影技术,找到异位妊娠的供血血管,经导管向子宫动脉灌注化疗药甲氨蝶呤（MTX）或氟尿嘧啶（5-FU）,然后选择710～1000μm的明胶海绵颗粒栓塞子宫动脉.术后观察患者的临床表现、生命体征、盆腔包块情况以及患者的绒毛膜促性腺激素（β-HCG）变化情况.结果35例患者均-次性插管,成功35例,成功率为100%.β-HCG呈进行性下降,均在1个月左右下降至正常值（〈2.9IU/L）,月经在术后1～2个月恢复正常.结论经子宫动脉化疗栓塞治疗异位妊娠对患者创伤小、成功率高,能预防大出血,增加保守治疗的适应证.

Objective To investigate the clinical effect of uterine arterial chemoembolization in the treatment of ectopic pregnancy. Methods 35 cases of ectopic pregnancy patients using standard angiography and find ectopic pregnancy the blood vessels, transcatheter uterine artery perfusion chemotherapy drug methotrexate （MTX） or 5-fuorouracil （5-FU）, and then select 710-1000 μm of polyvinyl alcohol （PVA） particle embolization of uterine artery. The clinical manifestations, vital signs, pelvic mass and the value of the chorionic gonadotropin （beta-HCG） were observed after surgery. Because of its relatively high cost, clinical only for the treatment of special types of ectopic pregnancy . Results All patients were one-time intubation, 35 cases were successful, the success rate was 100%. Chorionic gonadotropin （beta -HCG） showed a progressive decline, both in a month or so down to the normal value （〈2.9 IU/L）, menstruation in 1 to February after the return to normal. Conclusions Uterine arterial chemoembolization in the treatment of ectopic pregnancy in patients with small trauma, high success rate, to prevent internal bleeding is very effective, increase the indications of conservative treatment.