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目的探讨经双侧子宫动脉灌注甲氨蝶呤及介入栓塞治疗输卵管妊娠的临床应用。方法分析18例输卵管妊娠患者行双侧子宫动脉造影,甲氨蝶呤灌注栓塞对治疗前后患者的血β-hCG下降,B超检查及术后4个月子宫输卵管碘油造影检查(HSG)输卵管通畅率作为治疗效果的评价手段。结果 18例患者中17例患者治疗后复查B超提示胚胎缩小,β-hCG明显下降,阴道出血减少或中止,1例患者胚胎继续生长有内出血情况转手术治疗。4个月后17例患者行子宫输卵管碘油造影,15例通畅,通畅率83.3%。结论双侧子宫动脉灌注甲氨蝶呤化疗及介入栓塞术治疗输卵管妊娠是一种损伤小、疗效佳的治疗技术,是保守治疗输卵管妊娠的有效方法。
Objective To investigate the clinical application of bilateral uterine artery infusion of methotrexate and interventional embolization in the treatment of tubal pregnancy. Methods 18 cases of tubal pregnancy patients underwent bilateral uterine artery angiography, methotrexate perfusion and embolization of patients before and after treatment of blood β-hCG decreased, B-ultrasound and 4 months after hysterosalpingography (HSG) fallopian tube Patency as a therapeutic measure of effectiveness. Results Of the 18 patients, 17 cases underwent B-ultrasound examination after treatment showed that the embryo was reduced, the β-hCG was significantly decreased, the vaginal bleeding was reduced or stopped, and one patient continued to grow with internal bleeding and turned to surgery. Four months later, 17 patients underwent hysterosalpingography, with 15 cases of patency and patency rate of 83.3%. Conclusion Bilateral uterine arterial infusion of methotrexate chemotherapy and interventional embolization for the treatment of tubal pregnancy is a small injury, good curative effect of treatment, is an effective method of conservative treatment of tubal pregnancy.