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目的 :探讨输卵管妊娠的血供特征及子宫动脉一次性灌注氨甲喋呤 (MTX)及栓塞的临床疗效。材料与方法 :2 4例输卵管妊娠 (未破裂者 10例 ,发生流产或破裂者 14例 )行子宫动脉造影并灌注MTX 5 0～ 80mg及明胶海绵颗粒栓塞 ,术后定时监测尿人绒毛膜促性腺激素 (β hCG)及肿块变化。 6例未破裂者 ,治疗前行彩色多普勒超声观察宫旁肿块血流特征。结果 :宫旁肿块为富血管染色 ,具有较低血流阻力指数 (RI 0 37)。 2 1例治疗成功 ,成功率为 87 5 %。 3例失败 ,其中 2例术前尿 β hCG >10× 10 3IU/L。影响治疗成功的主要因素为术前尿 β hCG水平 ,而与孕龄、包块大小及破裂与否无明显关系。结论 :经子宫动脉一次性灌注氨甲喋呤及栓塞治疗输卵管妊娠安全有效 ,且可预防和控制破裂大出血
Objective: To investigate the blood supply characteristics of tubal pregnancy and uterine artery perfusion methotrexate (MTX) and the clinical efficacy of embolization. MATERIALS AND METHODS: Twenty-four cases of tubal pregnancy (10 without rupture, 14 with abortion or rupture) underwent uterine artery angiography and perfused with MTX 50-80mg and gelatin sponge particles. Urine human chorionic gonadotropin Gonadal hormone (β hCG) and mass changes. 6 cases were not ruptured, color Doppler ultrasound before treatment of parametrial mass flow characteristics. Results: The parathyroid mass was vascularized and had a lower blood flow resistance index (RI 0 37). 21 cases of successful treatment, the success rate of 87 5%. 3 cases failed, including 2 cases of preoperative urine β hCG> 10 × 10 3IU / L. The main factors affecting the success of the treatment of preoperative urinary hCG levels, but with gestational age, mass size and rupture or not no significant relationship. Conclusion: A single infusion of methotrexate and embolization via the uterine artery is safe and effective for tubal pregnancy, and can prevent and control rupture of hemorrhage