【作者】 倪才方； 邹建伟； 赵辉； 金泳海； 朱晓黎； 刘一之； 何琦； 沈仲姬；

【Author】 NI Cai-fang* He Qi Zou Jian-wei *Department of Interventional Radiology,The First Affiliated Hospital,Suzhou University,Suzhou 215006,China.

【机构】 苏州大学附属第一医院介入科； 苏州大学附属第一医院妇产科；

【摘要】 探讨经子宫动脉内插管灌注和栓塞治疗输卵管妊娠的可行性、安全性和疗效。方法:采用改良 seldinger 技术,对42例输卵管妊娠患者进行超选择性子宫动脉插管造影,根据造影表现类型不同,灌注 MTX50～100mg,灌注后用明胶海绵颗粒栓塞子宫动脉。术前和术后观察临床症状、血 D-HCG 值、妊娠囊大小的变化,术后分别于0.5、6、12、24、36、48小时测量 MTX 外周血药浓度。结果:42例中38例获得成功,4例失败改行手术或腹腔镜治疗。42例患者治愈率为90.5%(38/42)。术后血 D-HCG 水平下降至正常平均所需时间(8.26±2.04)d,MTX 用量为50mg、75mg 的36小时测不出血药浓度,用量为100mg 的48 小时后血药浓度均值为0.01 umol/L。无不良反应发生。结论:经子宫动脉内插管灌注和栓塞治疗输卵管妊娠的方法简便、安全、有效,无明显并发症。是输卵管妊娠特别是合并少量出血或预防高危大出血的首选治疗方法使用。更多还原

【Abstract】 Objective:To study the feasibility and safety of the treatment of tubule pregnancy by interventional technique.Methods:By using Seldinger method,42 case of tubule pregnancy received super-selective angiography of uterine artery,Followed by perfusion of 50-100mg methotr- exate (MTX) through the cathter and embolization of uterine artery with gelatin sponge.Before and after the procedure,patients showed changes of clinical symptom,physical signs,value of β-HCG and size of pregnancy cyst were studied.Value of MTX in peripheral blood were studied at 0.5、6、 12、24、36、48 hours after operated.Results:The cure rate in total 42 cases achieved 90.5%(38/42). The average time that value of β-HCG decreased to normal was 8.26±2.04 days.The lever of MTX in peripheral blood that apUy for 50mg and 75mg could not detected after operated 36 hours later,which apllied for 100mg was 0.01 umol/L at 48 hours after operated.Conclusion:It is safe and efficient in performing trans-uterine artery chemo-embolization for therapy of fallopian tubal pregnancy,Especialiy for those who complicated with manipulus bleeding or be prevented hemorrhoea.更多还原