三维超声对全身与局部给予氨甲喋呤治疗输卵管妊娠效果和安全性的评价

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (10): 1201-1202.

三维超声对全身与局部给予氨甲喋呤治疗输卵管妊娠效果和安全性的评价

曹晓桦¹, 李晖²

1. 解放军第157医院特诊科, 广东, 广州, 510510;
2. 解放军第157医院妇产科, 广东, 广州, 510510

出版日期:2004-10-20 发布日期:2004-10-20
基金资助:
收稿日期:2004-5-12。
作者简介:曹晓桦(1956- ),女,副主任技师,研究方向为腹腔B超,电话:020-61657143

Three-dimensional ultrasound evaluation of the efficacy and safety of single-dose systemic or local methotrexate injection for tubal pregnancy

CAO Xiao-hua¹, LI Hui²

1. 解放军第157医院特诊科, 广东, 广州, 510510;
2. 解放军第157医院妇产科, 广东, 广州, 510510

Online:2004-10-20 Published:2004-10-20

摘要/Abstract

摘要： 目的采用三维超声检测方法对肌肉注射及在B超引导下局部注射单剂氨甲喋呤(MTX)治疗输卵管妊娠方法的临床效果和安全性进行评价。方法肌肉注射组127例,单剂肌肉注射MTX50mg/m²;在B超引导下局部注射给药组118例,单剂给予MTX100mg。采用三维超声对囊胚用药前后体积、用药1周的囊胚扩大速度、囊胚溶解所需时间和血β-人绒毛膜促性腺激素水平进行监测,并通过输卵管图像三维重建方式对输卵管再通情况进行检测。结果局部注射组治疗成功率100%,显著高于肌肉注射组的91.34%;用药1周后囊胚扩大速度肌肉注射组为(0.85±0.04)cm³/d,局部注射组为(0.47±0.03)cm³/d,两组有显著差异(P<0.05);局部注射组囊胚溶解时间为(27.66±12.77)d,肌肉注射组为(32.62±12.75)d,两组有显著差异(P<0.05),并且治疗后输卵管畸形率局部注射组要显著低于肌肉注射组。结论在B超引导下局部注射MTX对未破裂输卵管妊娠是一种较安全、高效可靠的保守治疗方法,其治疗效果优于肌肉注射给药方法。

Abstract: Objective To compare the efficacy and safety of single-dose systemic and local injection of methotrexate (MTX) in the treatment of tubal pregnancy (TP).Methods The systemic group included 127 women with TP who received a single-dose MTX of 50mg/m² given by intramuscular injection,and the local group included 118 women receiving single-dose MTX of 100 mg via local injection guided by three-dimensional (3D) ultrasound. The volume of ectopic masses and blood β-human chorionic gonadotropin (β-HCG) were measured before and after MTX administration. The TP was detected by 3D images reconstructed 3 months after MTX administration. Results The success rate of treatment was 100% in the local group,signi- ficantly higher than that of 91.34% in the systemic group. After the first week of MTX injection,the speed of the ectopic mass resolution was 0.85±0.04cm³/d and 0.47±0.03cm³/d in systemic group and local group respectively (P<0.05),and the time of the ectopic mass resolution was 27.66±12.77 d and 32.62±12.75 d,respectively (P<0.01). The rate of tubal deformity in the local group was significantly lower than that in the systemic group.Conclusion Local injection of MTX under ultrasound guidance is safe,efficient and reliable for conservative management of unruptured TP,which is superior to systemic injection.

中图分类号:

R714.221

曹晓桦¹, 李晖². 三维超声对全身与局部给予氨甲喋呤治疗输卵管妊娠效果和安全性的评价[J]. 南方医科大学学报, 2004, 24(10): 1201-1202.

CAO Xiao-hua¹, LI Hui². Three-dimensional ultrasound evaluation of the efficacy and safety of single-dose systemic or local methotrexate injection for tubal pregnancy[J]. Journal of Southern Medical University, 2004, 24(10): 1201-1202.

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