经皮子宫动脉介入灌注栓塞治疗输卵管妊娠观察  

Clinical observation of percutaneous uterine artery interventional embolization for tubal pregnancy

作　　者：耿旭[1] 徐浩 GENG Xu;XU Hao(Department of Interventional Radiology,Chinese Traditional Hospital of Shuyang,Shuyang 223600,China;Department of interventional Radiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]沭阳县中医院,江苏沭阳223600 [2]徐州医科大学附属医院,江苏徐州221006

出　　处：《延安大学学报（医学科学版）》2020年第2期70-73,共4页Journal of Yan'an University:Medical Science Edition

摘　　要：目的探讨经皮子宫动脉介入灌注栓塞治疗输卵管妊娠的可行性、临床疗效及安全性。方法对16例输卵管妊娠患者行子宫动脉插管,根据术前血清人绒毛膜促性腺激素(β-HCG)水平、体重及造影表现,灌注不同剂量甲氨蝶呤,然后行明胶海绵颗粒栓塞。术后监测血清β-HCG、谷丙转氨酶(ALT)和谷草转氨酶(AST)水平,临床观察有无妊娠囊破裂表现。结果16例患者均行插管治疗,技术成功率100%。术后随访观察2月,1例患者因血清β-HCG水平持续增高行腹腔镜手术,15例患者血清β-HCG水平40天内均降至正常范围,治疗成功率93.7%;1例患者因术后孕囊破裂行手术治疗,临床成功率87.5%。术后3年内5例患者再次正常妊娠分娩。结论经皮子宫动脉介入灌注栓塞治疗输卵管妊娠安全有效,可作为具有较高血清β-HCG水平且既往有一侧输卵管切除史患者的首先方法。Objective To investigate the feasibility,clinical efficacy and safety of percutaneous uterine artery embolization for tubal pregnancy.Methods Sixteen cases of tubal pregnancy were treated with uterine artery intubation.According to preoperative bloodβ-HCG level,weight and imaging performance,different doses of methotrexate were injected,and then gelatine sponge granules were used to embolize the uterine artery.Postoperative bloodβ-HCG,ALT and AST level were monitored,and clinical observation was performed for the rupture of pregnancy vesicles.Results All cases were intubated and the technical success rate was 100%.Postoperative follow-up observed that bloodβ-HCG level of 15 patients dropped to the normal range in 40 days,and the treatment success rate was 93.7%.One patient was treated with open surgery due to rupture of a large pregnancy sac,and another patient was transferred to laparoscopic surgery for continues raise of bloodβ-HCG level,and the clinical success rate was 87.5%.During 3-year follow-up,5 patients had normal pregnancy delivery again.Conclusion Percutaneous uterine artery perfusion embolization is safe and effective in treating tubal pregnancy.It can be used as the first option for patients with higher bloodβ-HCG level or previously had a history of tubal resection.

关 键 词：介入治疗 输卵管妊娠 子宫动脉栓塞 

分 类 号：R714.22[医药卫生—妇产科学]