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目的研究超声引导下穿刺孕囊注入氨甲蝶呤治疗未破裂型输卵管妊娠的临床价值。方法采用经腹或经阴道超声引导和实时监视下用19G PTC针对18例未破裂型输卵管妊娠的孕囊进行穿刺,抽尽囊液,并注入氨甲蝶呤(MTX)20～40 mg,治疗后3 d、1周、半月、1个月、2个月复查超声检查和血β-HCG。结果治疗18例,治愈17例,1例在介入治疗随访过程中发生破裂改用腹腔镜手术治疗,介入治疗治愈率94.4%。结论超声引导下穿刺注入氨甲蝶呤治疗未破裂型输卵管妊娠具有操作简单、安全高效、创伤小、费用低等优点,可作为治疗未破裂型输卵管妊娠首选方法,尤其适用于渴望保留生育功能或已做过异位妊娠手术的患者。
Objective To study the clinical value of ultrasound-guided gestational sac injection of methotrexate in the treatment of unruptured tubal pregnancy. Methods The transabdominal or transvaginal ultrasound guidance and real-time monitoring of 19G PTC for 18 cases of unruptured tubal pregnancy gestational sac puncture, drained the cyst fluid and injected methotrexate (MTX) 20 ~ 40 mg, treatment After 3 d, 1 week, half a month, 1 month, 2 months review ultrasound and blood β-HCG. Results 18 cases were treated and 17 cases were cured. One case was treated by laparoscopic surgery during the follow-up of interventional treatment. The cure rate of interventional treatment was 94.4%. Conclusion Ultrasound-guided injection of methotrexate in the treatment of unruptured tubal pregnancy has the advantages of simple operation, safe and efficient, small trauma and low cost, which can be used as the first choice for the treatment of unruptured tubal pregnancy, especially for those who desire to retain reproductive function or Has done ectopic pregnancy surgery patients.