Timor-Tritsch I E, Monteagudo A, Lerner J P
Department of Obstetrics and Gynecology, Sloane Hospital for Women, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
Ultrasound Obstet Gynecol. 1996 May;7(5):353-5. doi: 10.1046/j.1469-0705.1996.07050353.x.
Puncture and injection (usually by methotrexate) of ectopic pregnancies are relatively new modalities of treatment. Lately, these have been applied to cornual ectopic pregnancies. We describe here a proposed transvaginal ultrasound-guided puncture route, leading the needle into the cornual ectopic pregnancy, first traversing the myometrium and approaching the gestational sac from the medical aspect. After extracting the needle, there is potentially less chance for rupture and bleeding. In six of the seven injected cornual pregnancies, this technique was used without complication. The only one punctured from the lateral aspect bled and required laparoscopic intervention. This technique may enable the wider use of this treatment modality by lowering the complication rate caused by bleeding at the puncture site.
穿刺和注射（通常使用甲氨蝶呤）治疗异位妊娠是相对较新的治疗方式。最近，这些方法已应用于宫角异位妊娠。我们在此描述一种经阴道超声引导的穿刺路径，将针引导至宫角异位妊娠处，首先穿过子宫肌层并从内侧接近妊娠囊。拔出针后，破裂和出血的可能性较小。在七例接受注射治疗的宫角妊娠中，有六例使用了该技术且无并发症。唯一一例从外侧穿刺的出现了出血，需要腹腔镜干预。该技术可能通过降低穿刺部位出血引起的并发症发生率，使这种治疗方式得到更广泛的应用。
