摘要
目的探讨简捷、安全、保留器官完整性的微创手术治疗异位妊娠的方法。方法对56例异位妊娠患者行右侧股动脉穿刺插管，超选择插入至患侧子宫动脉，造影观察病变的范围、血供来源及有无活动性出血，然后将甲氨蝶呤150mg粉剂稀释至100ml经导管缓慢注入子宫动脉，再用0．5mm×0．5mm×0．5mm的明胶海绵碎粒适量栓塞子宫动脉，至子宫动脉分支不显影为止，随访观察疗效。结果56例均成功实施了超选择性子宫动脉灌注栓塞术，无相关并发症。33例腹腔活动性出血患者栓塞后出血立即停止。13例胚胎存活患者第2天超声复查存活胚胎全部死亡。56例患者血绒毛膜促性腺激素β亚单位均在术后3—12d降至5U／L以下，腹腔积血1周后全部吸收。1个月后混合性包块完全吸收消失。术后3个月行子宫输卵管造影19例，11例显示患侧输卵管通畅。结论超选择性子宫动脉灌注栓塞治疗异位妊娠，能有效杀灭胚胎组织、栓塞破裂血管，止血效果明显，手术创伤小，且能保留输卵管。
Objective To probe a simple, safe, and minimally invasive method to treat ectopic pregnancy with preservation of the organs. Methods Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embolize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results Superselective uterine arterial infusion and embolization were successfully performed in all 56 patients without any related complications. Active bleeding in the peritoneum in 33 cases ceased soon after embolization The embryos in 13 patients were confirmed to have died by ultrasound two clays after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embolizing leaking arteries with the advantages of preserving the fallopian tubes.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第8期817-820,共4页
Chinese Journal of Radiology
关键词
异位
妊娠
出血
放射学
介入性
Pregnancy, ectopic
Hemorrhage
Radiology,interventional
作者简介
现在西安高新医院放射科，710075
