超声引导局部注射MTX对未破裂型宫外孕的治疗价值

The value of ultrasound guided local injection of MTX in the treatment of non ruptured ectopic pregnancy

目的探讨超声引导局部注射甲氨喋呤(MTX)治疗未破裂型宫外孕的效果。方法对32例未破裂型宫外孕患者进行超声引导下经阴道穿刺局部注射MTX 50mg,对术后监测仅血β-HCG下降缓慢者(<15%)行2次穿刺注药;宫角妊娠、宫颈妊娠、切口妊娠均在术后监测血β-HCG下降至2000IU/L以下,宫外孕包块缩小且周围血流信号明显减少条件下,行清宫术;术后出现手术指征患者改行手术治疗。结果 32例早期宫外孕患者经穿刺局部药物注射保守治疗,31例患者保守治疗成功,1例输卵管妊娠患者保守治疗失败,治愈率为96.85%。结论超声引导经阴道穿刺局部注射甲氨喋呤(MTX)对未破裂型宫外孕的治疗疗效显著、简便、经济、安全、副作用少。

Objective To study the effect of ultrasound guided local injection of methotrexate （MTX） treatment for the unruptured ectopic pregnancy. Methods 32 cases of unruptured ectopic pregnancy patients underwent ultrasound-guided via vaginal puncture and local injection of MTX 50 mg. The postoperative monitoring of blood ~3-HCG decreased slowly （ 〈 15% ） made 2 times puncture and injection of medicine; Curettage was carried out under the conditions that the cornual pregnancy, cervical pregnancy, pregnancy at the incision were in the postoperative monitoring of blood 13-HCG dropped to below 2000 IU/L, ectopic pregnancy bag block reduced and the signal of peripheral blood flow significantly reduced ; postoperative emergence surgical indications were diverted to surgery, Results 32 cases of early ectopic pregnancy were treated with conservative treatment, 31 cases with conservative treatment, 1 case of tubal pregnancy with conservative treatment failed. The cure rate was 96.85%. Conclusion Ultrasound-guided via transvaginal puncture and local injection of methotrexate （MTX） for unruptured ectopic pregnancy has significant ＇curative effect, which is simple, less economic, safe and side effects.