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目的研究经动脉药物灌注栓塞治疗输卵管妊娠的疗效、输卵管解剖及卵巢功能变化。方法对30例明确诊断输卵管妊娠的患者,行超选择子宫动脉造影后经导管注入MTX(氨甲喋呤)60~100 mg,用明胶海绵颗粒对子宫动脉行完全性栓塞。对其中15例未生育患者术前及术后3、6月分别测定其性激素水平,术后第3次月经后行子宫输卵管造影。结果29例患者经治疗后2~3周孕囊缩小,血-βhCG(人绒毛膜促性腺激素)值下降至正常(小于30 mIU/ml),其中15例术后女性激素水平无变化,输卵管通畅;1例由于术前孕囊较大,术后第2天孕囊破裂,行手术治疗。结论经子宫动脉化疗及栓塞是治疗输卵管妊娠的有效方法,可有效保留卵巢及输卵管的生理及解剖功能。
Objective To study the curative effect, tubal anatomy and ovarian function of tubal pregnancy treated by arterial infusion and embolization. Methods Thirty patients with definite diagnosis of tubal pregnancy underwent transcatheter arterial infusion of MTX (methotrexate) 60 ~ 100 mg. The complete embolization of uterine artery with gelatin sponge particles was performed. 15 cases of non-fertile patients were measured before and after 3,6 months of sex hormone levels were measured after the third menstruation after hysterosalpingography. Results The gestational sac size was reduced in 29 patients at 2 ~ 3 weeks after treatment, and the blood-βhCG (human chorionic gonadotropin) value decreased to normal (less than 30 mIU / ml). No change was found in the postoperative women’s hormone levels. Unobstructed; 1 case of preoperative gestational sac larger, 2nd day after pregnancy sac rupture, surgical treatment. Conclusion Uterine artery chemotherapy and embolization is an effective method for the treatment of tubal pregnancy, which can effectively preserve the ovarian and fallopian tube physiology and anatomy.