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目的:探讨经阴道超声引导下后穹窿穿刺注入药物治疗输卵管妊娠的临床疗效。方法:纳入输卵管妊娠患者78例,患者外阴、会阴部常规消毒后,采用洗必太盐水消毒阴道内部,探头套消毒套后安装穿刺导向器,采用超声仪经阴道探头配合穿刺导向器,将穿刺针刺入输卵管妊娠囊内,先以0.2%甲硝唑冲洗囊腔,再向妊娠囊内注入生理盐水稀释的甲氨蝶呤50mg,快速退出穿刺针。结果:治疗成功率为95%,1次穿刺成功68例,10例经2次穿刺成功,穿刺后血HCG逐渐降低,总计耗时10～25d,平均14天。结论:经阴道超声引导下后穹窿穿刺注入药物治疗输卵管妊娠安全可靠,治疗时间短,不良反应小,值得临床推广应用。
Objective: To investigate the clinical effect of transvaginal ultrasound guided posterior fornix injection into tubal pregnancy. Methods: 78 cases of tubal pregnancy were enrolled. After routine disinfection of vulva and perineum, chlorhexidine chloride was used to sterilize the vagina. After the probe sleeve was disinfected, a puncture guide was installed. The transvaginal probe was used with the ultrasound to guide the puncture guide. Needling into the tubal pregnancy sac, the first 0.2% metronidazole flushing the cyst, and then into the gestational sac of saline diluted methotrexate 50mg, quickly exit the needle. Results: The success rate of treatment was 95%, 68 cases were successful in one puncture and 10 cases were successful in 2 punctures. The blood HCG decreased gradually after puncturing, which took 10 ~ 25 days and averaged 14 days. Conclusion: Transvaginal ultrasound-guided posterior fornix injection of tubal pregnancy is safe and reliable, the treatment time is short, and the adverse reaction is small, which is worthy of clinical application.