DSA引导下不同甲氨蝶呤给药方式对未破裂输卵管妊娠的治疗效果

Effect of different methotrexate administration methods under DSA guidance on the treatment of unbroken tubal pregnancy

目的探讨妊娠囊内注射甲氨蝶呤(MTX)对未破裂型输卵管妊娠患者终止妊娠的治疗效果。方法将86例未破裂型输卵管妊娠患者随机分为两组,每组43例。保守治疗组肌注MTX进行治疗,介入治疗组在DSA引导下于患者输卵管妊娠囊内一次性注射MTX进行治疗。观察比较两组患者妊娠囊直径、血清β-人绒毛膜促性腺激素(β-hCG)、输卵管通畅率及不良反应发生情况。结果介入治疗组患者比保守治疗组妊娠囊直径缩小更明显(P<0.001),血清β-hCG降低更显著(P<0.001),输卵管通畅率更高(P<0.05),恶心、呕吐等不良反应发生率更低(P<0.05)。结论未破裂型输卵管妊娠囊内注射MTX介入治疗方法简单,疗效显著,安全性好,输卵管通畅率高。

Objective To investigate the effect of injecting methotrexate(MTX)into the pregnancy sac on unbroken tubal pregnancy.Methods 86 cases of unbroken tubal pregnancy were randomly divided into two groups.The conservative treatment group was treated with intramuscular injection of MTX,and the interventional treatment group was treated with injection of MTX into the pregnancy sac under the guidance of DSA.The diameter of the pregnancy sac,human chorionic gonadotropin(β-hCG),fallopian tube patency rate and adverse reaction of the two groups were compared.Results In the interventional treatment group,the diameter of the pregnancy sac was clearly less than that in the conservative treatment group(P<0.001),the serumβ-hCG decreased more significant(P<0.001),the fallopian tube was more unobstructed(P<0.001),and the side effect of nausea and vomiting were less.Conclusion Intramuscular injection of MTX into pregnancy sac are effective and safe in the treatment of unbroken tubal pregnancy,which has high patency rate of fallopian tube and high popularization value.