宫腔镜下甲氨蝶呤注入输卵管保守治疗非破裂型输卵管妊娠的疗效观察

目的探讨宫腔镜下甲氨蝶呤注入输卵管保守治疗非破裂型输卵管妊娠的临床疗效。方法对34例确诊为非破裂型输卵管妊娠,且包块直径≤4 cm,血β-HCG〈2 000 IU,无腹腔积液的病例,行宫腔镜下将MTX 40 mg注入输卵管;动态观察患者血HCG变化,定期复查彩超,观察包块变化情况。结果32例治愈,治愈率94.12%。其中有1例疗程结束后1周复查血β-HCG〉1000 u/L,追加用药后成功;失败2例,均因治疗期间腹痛加剧出现内出血征象而转行手术治疗,内出血分别为700 ml、480 ml,转腹腔镜手术,恢复良好。结论宫腔镜下甲氨蝶呤注入输卵管保守治疗非破裂型输卵管妊娠具有损伤小、避免开腹手术等优点,值得临床推广。

Conservative Hysteroscopic Tubal Injection of Methotrexate Treatment of Unruptured Tubal Pregnancy Treatment

Objective Conservative hysteroscopic tubal injection of methotrexate treatment of unruptured tubal pregnancy clinical efficacy.Methods 34 cases diagnosed as non-ruptured tubal pregnancy,and the mass diameter≤4cm,serumβ-HCG2 000 IU,no case of ascites,under hysteroscopic tubal to MTX 40 mg injection, dynamic observation of patients HCG blood changes,periodic review ultrasonography,observed mass changes. Results 32 patients were cured,the cure rate 94.12%.Among them,1 case 1 week after treatment,review of bloodβ-HCG1000 u/L,additional after treatment success;failure,2 cases were due to increased internal bleeding during treatment,abdominal pain sign of the switch surgery,internal bleeding were 700 ml,480 ml,switch to laparoscopic surgery,a good recovery.Conclusion conservative hysteroscopic tubal injection of methotrexate treatment of unruptured tubal pregnancy with less damage,to avoid open surgery and is worth in clinical practice.