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Interventional radiology treatment of unruptured tubal pregnancy


Key words tubal pregnancy; methotrexate; intervention
[Abstract] Objective To evaluate the involvement of new methods of tubal pregnancy, and other drug treatment comparison. Methods 36 cases of unruptured tubal pregnancy were randomly divided into A, B, C 3 groups, A group: simple drug quality group (control group ), methotrexate 50 mg/m2, a single intramuscular injection. Group B: luminal injection of tubal pregnancy intervention group (treatment group Ⅰ), the X-ray, 76% diatrizoate line hysterosalpingography, uterine and tubal morphology, a clear sac location, shape, sending Cook catheter guide wire into the fallopian tube to test tube, as far as possible away from the gestational sac nearer, slowly injected through the catheter (1.5 ml / min) methotrexate 40 mg +50% GS 2.5 ml +76% 0.5 ml diatrizoate mixture. Group C: involvement of tubal pregnancy gestational sac injection treatment group (treatment group Ⅱ) and intubation with the B method, tubal surgery using the guide wire punctured the gestational sac, methotrexate directly into the pregnancy sac. The results of the control group cure rate 75.0% (9 / 12), the treatment group Ⅰ, the cure rate was 83.3% (10/12), the treatment group Ⅱ cure rate of 91.6% (11/12). 3 groups was significant difference between cure rates (P <0.05). Conclusion Interventional catheter treatment of tubal pregnancy,ralph lauren pas cher, delivery gestational sac is a safe, economic, and postoperative tubal patency rate of minimally invasive surgery for tubal conservative treatment of pregnancy provides a new method of treatment. [Keywords] tubal pregnancy; methotrexate; intervention tubal pregnancy is a common gynecological acute abdomen is one of about 95% of ectopic pregnancy. This year there is an upward trend in its incidence, first reported in 1982, with methotrexate (MTX) treatment of interstitial pregnancy after the success, MTX treatment of ectopic pregnancy, widely used in clinical practice. Our hospital in October 2005 - June 2006 36 cases of unruptured tubal pregnancy were to take a different conservative treatment methods, and treatment comparison, results were satisfactory, are as follows. 1 Materials and Methods 1.1 General Information Select I hospital outpatient and inpatient services. (1) inclusion criteria: ① tubal pregnancy mass diameter <4 cm. ② unruptured tubal pregnancy or miscarriage. ③ no significant bleeding. ④ serum β-HCG <200 u / L (reference Yue Jie 5th edition of Obstetrics and Gynecology indications for conservative treatment of tubal pregnancy, chemotherapy). (2) Exclusion criteria: liver, kidney function, blood clotting abnormalities, serious medical disorders. Selected objects, 36 cases were randomly divided into 3 groups of 12 cases. Aged 17 to 38 years, mean (28.4 ± 6.3) years of age, menopause 34 to 65 days 30 patients, other non-history of menopause, showed irregular small amount of vaginal bleeding 33 cases accounted for 91.6%; abdominal pain 23 cases 63.9%; with rings 6 cases accounted for 16.6%; six cases of unmarried; three cases of infertile marriage. 1.2 Control group: reference Music Kit Version 5 of Obstetrics and Gynecology conservative treatment of tubal pregnancy, chemotherapy, methotrexate 50 mg/m2 , a single intramuscular injection, 4 to 7 days after treatment, serum β-HCG decreased <15%, again on the 7th day intramuscular methotrexate. Treatment group Ⅰ: lithotomy position, routine disinfection, shop towels, 76% diatrizoate line hysterosalpingography, uterine and tubal morphology, a clear gestational sac location, shape, and then into the fallopian tube Cook catheter guide wire to test tube as far as possible away from the gestational sac nearer, slowly injected through the catheter (1.5 ml / min) methotrexate 40 mg +50% GS 2.5 ml +76% diatrizoate mixture of 0.5 ml. If after 4 to 7 days decreased serum β-HCG <15% at 7 days and then tubal intervention. Treatment group Ⅱ: group Ⅰ treatment approach with intubation, patients using the guide wire punctured tubal gestational sac, methotrexate directly into the pregnancy sac, such as after 4 to 7 days decreased serum β-HCG <15% in 7 days and then tubal intervention. 1.3 standard for treatment failure after abdominal pain increased, significant intra-abdominal hemorrhage, increased serum β-HCG or down; B-show pelvic mass increase or reduce, to laparotomy for failure. 1.4 standard clinical cure symptoms; β-HCG blood test every week until reduced to the normal range, adnexal mass shrink or disappear; pelvic effusion decreased or disappeared. 1.5 statistical methods using SPSS statistical software, to take t-test measurement data, calculations take χ2 test. 2 results 2.1 3 Comparison of the control group treated 6 cases of treatment group 1 week after serum β-HCG decreased ≥ 15%, pelvic mass is not increased, narrowing> 50% of the no-medication, hospital outpatient follow-up. 6 cases 1 week after treatment serum β-HCG decreased 50% of the no-medication, hospital outpatient follow-up. Three cases were in medication for 4 days, 6 days, 7 days severe abdominal pain, serum β-HCG was significantly increased,abercrombie paris, B-shows an increase in intra-abdominal bleeding, pelvic mass increased significantly, to surgery. 75% cure rate, the average length of stay 11.6 days. Treatment group Ⅰ, 10 patients 1 week after treatment serum β-HCG decreased ≥ 15%, pelvic mass is not increased, narrowing> 50% of the no-medication, hospital outpatient follow-up. 2 patients on the medication for 4 days, 6 day of severe abdominal pain, serum β-HCG was significantly increased, B-shows an increase in intra-abdominal bleeding, pelvic mass increased significantly, to surgery. Cure rate of 83.3%, the average hospital stay of 9 days. Treatment group Ⅱ in 11 patients 1 week after treatment serum β-HCG decreased ≥ 15%,abercrombie paris, pelvic mass is not increased, narrowing> 50% of the no-medication,abercrombie paris, hospital outpatient follow-up. 1 case of severe abdominal pain 5 days treatment, significantly increased serum β-HCG, B-shows an increase in intra-abdominal bleeding, pelvic mass increased significantly, to surgery. 91.6% cure rate, the average length of stay 7.3 days. 3 groups was significant difference between cure rates (P <0.05). Table 1. More articles related to topics：


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