超声引导经皮射频消融治疗异位妊娠的临床效果

Clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy

目的探讨超声引导经皮射频消融治疗异位妊娠的临床效果。方法回顾性分析2018年1月至2020年1月郑州大学第一附属医院收治的8例异位妊娠患者,均行超声引导经皮射频消融治疗。术后即刻行超声造影,观察术后妊娠囊变化;记录患者住院时间、包块吸收时间及恢复月经时间,观察术后并发症情况及血清人绒毛膜促性腺激素(HCG)转阴时间;于术后3个月,月经干净后3~7 d行子宫输卵管造影检查,观察输卵管通畅情况;随访1年,观察术后宫内妊娠及再次异位妊娠情况。结果8例患者均成功行射频消融治疗,术后超声造影示包块持续无强化;住院时间(3.0±0.8)d,包块吸收时间(32.4±14.3)d,恢复月经时间(39.6±2.7)d,均未出现严重并发症;血HCG水平1周内迅速降低,均在术后2~3周恢复至正常未孕水平。术后3个月输卵管造影检查示3例患者输卵管再通;随访1年,1例患者自然宫内妊娠,无再次出现异位妊娠病例。结论超声引导经皮射频消融治疗异位妊娠疗效显著、创伤小、恢复快,可在一定范围内保留患者的生殖能力,值得临床应用推广。

Objective To investigate the clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy.Methods A retrospective analysis was performed on 8 patients with ectopic pregnancy admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020,all of whom underwent ultrasound-guided percutaneous radiofrequency ablation.Contrast ultrasonography was performed immediately after the operation to observe the changes of pregnancy sac.The length of hospital stay,mass absorption time and menstrual recovery time of the patients were recorded.Postoperative complications and serum human chorionic gonadotropin(HCG)negative conversion time were observed.At 3 months after the operation,hysterosalpingography was performed 3-7 days after the menstruation to observe the patency of the fallopian tubes,all patients were followed up for 1 year to observe the postoperative intrauterine pregnancy and re-ectopic pregnancy.Results All the 8 patients were successfully treated with radiofrequency ablation,and postoperative ultrasonography showed that the mass remained unenhanced.The length of hospital stay was(3.0±0.8)d.The packet absorption time was(32.4±14.3)d.The recovery time of menstruation was(39.6±2.7)d.There were no serious complications.Blood HCG levels decreased rapidly within a week,and all returned to normal level of non-pregnancy 2-3 weeks after the operation.Three months after the operation,the salpingogram showed that the fallopian tubes were recanalized in 3 patients.After a follow-up of 1 year,1 patient had a natural intrauterine pregnancy,and there was no case of recurrent ectopic pregnancy.Conclusions Ultrasound-guided percutaneous radiofrequency ablation is effective in the treatment of ectopic pregnancy with minimal trauma and rapid recovery,and can retain the reproductive ability of patients to some extent,which is worth popularizing in clinical application.