未破裂期输卵管妊娠的介入治疗  

Interventional treatment of unruptured tubal pregnancy

作　　者：单鸿[1] 马壮[1] 姜在波[1] 严英[2] 关守海[1] 朱康顺[1] 黄明声[1] 陈汉威 

机构地区：[1]中山医科大学附属第三医院放射科,广州510630 [2]广州中医药大学附属第一医院 [3]广东省番禺市人民医院

出　　处：《中华放射学杂志》2000年第2期78-80,共3页Chinese Journal of Radiology

摘　　要：目的　加强对输卵管妊娠介入治疗中所存在的若干问题的认识。方法　 40例未破裂输卵管妊娠患者 ,经阴道输卵管或经子宫动脉两种途径灌注氨甲喋呤治疗 ,选用Rosch Thurmoud输卵管再通装置 ,以及 4 1～ 5 0F导管。超声和尿人绒毛膜促性腺激素 (β hCG)值的变化是监测本组治疗效果的主要指标。结果　 12例接受经阴道输卵管孕囊内注射治疗 15次 ,其中 3例接受 2次药物注射 ;2 8例接受子宫动脉内插管治疗。终止妊娠总体成功率为 97 5 % ;尿 β hCG值平均下降时间为11 7d(4～ 2 8d) ;正常月经在治疗后 7～ 45天内恢复。结论　通过对输卵管妊娠病理学、胚囊发育与血供特点、血清与尿液hCG值变化的认识 ,有助于介入技术在该领域中更好地推广。Objective To discuss some concept about interventional treatment of tubal pregnancy Methods The procedure of transvaginal tubal intra gestational SAC injection (IGSI) or percutaneous intra uteroarterial infusion (IUAI) was selected for treatment of 40 patients with unruptured tubal pregnancy. Methotrexate(MTX), Rosch Thurmoud fallopian tube catheterization set, and the general angiographic catheters of 4 1-5 0 F were uesd for the procedure. Ultrasound and urine beta hCG were the main indexes monitoring the therapeutic effects in this study Results 12 of 40 patients underwent a total of 15 IGSI Of these, 3 patients required a second injection; 28 of 40 cases were treated with IUAI The total successful rate of termination of ectopic pregnancy was 97 5%, the mean resolution time for reduction of beta hCG concentration was 11 7 days (range 4-28), the range of menstruation recovery time was 7-45 days Conclusion The interventional therapy for tubal pregnancy will be more widely applied, on the basis of a better understanding about the pathology, characteristics of embryonic sac development and blood supply, the regular change of concentration of serum and urine hCG in tubal pregnancy

关 键 词：输卵管妊娠 介入性放射学 异位妊娠 介入疗法 

分 类 号：R714.221[医药卫生—妇产科学] R816.91[医药卫生—临床医学]