腔内超声引导细针穿刺异位妊娠囊注射氨甲喋呤治疗宫外孕的研究  

Cavity Ultrasound-guided Fine-needle Aspiration of Ectopic Pregnancy Sac Injection of Methotrexate Treatment of Ectopic Pregnaney

作　　者：侯智文[1] 李文伦[1] 赵明霞[1] 王丽红[1] 王军华[1] 

机构地区：[1]潍坊市人民医院超声科,山东省潍坊市261041

出　　处：《中国超声医学杂志》2009年第5期501-503,共3页Chinese Journal of Ultrasound in Medicine

基　　金：潍坊市科研基金自助项目（No.20050901）

摘　　要：目的探讨腔内超声引导异位妊娠囊穿刺注射氨甲喋呤（MTX）治疗宫外孕的效果。方法将80例早期未破裂型宫外孕患者分成两组,A组60例,B组20例。A组在经阴道超声引导下,应用日本产21G长250 mm穿刺针穿刺异位妊娠囊,抽净囊液后,将MTX40 mg分别用生理盐水2 ml溶解后注入妊娠囊内;B组应用MTX-CF方案,MTX1 mg/kg＋10%葡萄糖溶液500 ml,静脉注射,隔日1次（1、3、5、7 d）,共4次;甲酰四氢叶酸（CF）0.1 mg/kg,肌肉注射,隔日1次（2、4、6、8 d）,4次。结果A组患者1次治疗成功55例（91.7%）,2次治疗成功5例（8.3%）,3 d超声复查,妊娠囊缩小,胚芽及原始心管搏动消失,血β-hCG降低,2-3个月超声复查囊块消失;B组1个疗程治愈12例（60.0%）,无效8例（40.0%）,其中破裂4例,改为手术治疗,另4例治疗后无效,改为A组治疗,A组治愈率100%,B组治愈率60.0%,两组比较,P〈0.05。结论经阴道超声引导妊娠囊穿刺注射MTX治疗早期未破裂型宫外孕对患者损伤小,痛苦轻,治愈时间短且治愈率高,该法是一种有效的治疗方法。Objective Cavity of ultrasound-guided fine-needle aspiration of ectopic pregnancy sac injection of methotrexate （MTX） treatment of eetopic pregnancy results. Methods 80 cases of early non-ruptured ectopic pregnancy patients were divided into two groups, A group of 60 eases, B group of 20 cases. In Group A transvaginal ultrasound-guided, the application of Japanese-21 G-250 mm puncture needle aspiration of ectopic pregnancy sac, out of the net after the capsule will MTX 40 mg with 2 ml normal saline solution injected into pregnancy after the capsule; B group of MTX- CF programme, MTX 1 mg/kg＋10% glucose solution 500 ml, intravenous injection, once every other day （1, 3 , 5 , 7 d）, 4 times; formyl relationship 0.1 mg/ kg, intramuscular, once every other day （2, 4, 6 d）, 4 times. Results A group of the treatment of patients with a successful 55 cases （91.7%）, two successful treatment of five cases （8.30%）, 3 d ultrasound review, the pregnancy sac narrow, and the original germ of the heart throb disappeared, lower blood β-hCG, 2 - 3 months ultrasonic inspection capsule block disappear; B group a course of treatment cured 12 cases （60%）, invalid eight cases （40%）, including four cases of rupture, to surgical treatment, and the other four cases after treatment does not work, to Group a treatment, and the B group, P〈 0. 05. Conclusions Transvaginal ultrasound-guided injection of MTX pregnancy sac puncture early treatment of patients with ruptured ectopic pregnancy to injury, suffering light, the cure time is short, is an effective treatment methods.

关 键 词：宫外孕 经阴道超声 氨甲喋呤 妊娠囊 

分 类 号：R711[医药卫生—妇产科学]