Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
Scott Med J. 2011 Nov;56(4):214-9. doi: 10.1258/smj.2011.011161.
Our aim was to explore the clinical application value of high-intensity focused ultrasound (HIFU) therapy for tubal pregnancy. Forty hospitalized patients with tubal pregnancies (28 cases of non-ruptured tubal pregnancy and 12 cases of ruptured tubal pregnancy) were selected to receive HIFU therapy. Serum human chorionic gonadotropin (β-HCG) concentrations were compared before and after treatment. Serum β-HCG was measured weekly and patients received observation only if the concentration decreased by 15% or more, compared with the previous value. Patients were given supplement HIFU therapy if the decrease in the serum β-HCG was <15% within two weeks. Ultrasound was used to detect the volume changes in the ectopic lesions before and after treatment, and changes in vital signs and complications were recorded. Contrast-enhanced ultrasonography was used to assess fallopian tube patency after treatment. HIFU treatment was successful in 33 of the 40 patients (82%). Seven patients failed HIFU treatment and received surgical therapy (18%). Before and after treatment, serum β-HCG concentrations and lesion volume were significantly different (P < 0.05, P < 0.01, respectively). Post-treatment tubal contrast-enhanced ultrasonography showed tubal patency on the affected side in 21 cases (64%) at six months and in 27 cases (82%) at 12 months. In conclusion, HIFU is safe and effective, and can be a treatment option for tubal pregnancy.
我们的目的是探讨高强度聚焦超声（HIFU）治疗输卵管妊娠的临床应用价值。选择 40 例住院输卵管妊娠患者（28 例未破裂输卵管妊娠，12 例破裂输卵管妊娠）接受 HIFU 治疗。比较治疗前后血清人绒毛膜促性腺激素（β-HCG）浓度。每周测量血清β-HCG，如果与前一次相比下降 15%或更多，则仅对患者进行观察。如果在两周内血清β-HCG下降<15%，则给予补充 HIFU 治疗。治疗前后用超声检测异位病灶的体积变化，并记录生命体征和并发症的变化。治疗后用增强超声评估输卵管通畅性。40 例患者中，33 例（82%）HIFU 治疗成功。7 例患者 HIFU 治疗失败，接受手术治疗（18%）。治疗前后血清β-HCG 浓度和病灶体积差异均有统计学意义（P<0.05，P<0.01）。治疗后输卵管造影显示，6 个月时患侧输卵管通畅 21 例（64%），12 个月时通畅 27 例（82%）。总之，HIFU 是一种安全有效的治疗方法，可作为输卵管妊娠的治疗选择。
