摘要
目的比较腹腔镜保守性手术与药物介入2种方法治疗输卵管妊娠的疗效。方法2002年3月-2004年3月，我们选择63例输卵管妊娠随机分为2组，分别行腹腔镜输卵管切开吸胚术及甲氨蝶呤（MTX）经输卵管注人术，比较2种手术的疗效。结果32例腹腔镜保守手术，一次手术成功31例，成功率为96．9％。药物介入治疗31例，一次注射杀胚成功23例，二次注射杀胚成功1例，成功率77．4％，2组成功率无统计学差异（x^2=3．765，P=0．052）。腹腔镜治疗成功者血β-hCG降至正常的时间为（9．1±2．1）d，明显短于药物介人组的（26．3±3．9）d，（t=-20．974，P=0．000）。结论腹腔镜保守手术和药物介入治疗输卵管妊娠均能有效保留妊娠侧输卵管。腹腔镜保守手术较药物介入治疗输卵管妊娠有更广泛的适应证，更小的副作用，血β-hCG能更早降至正常。
Objective To compare curative effects between laparoscopic oviduct-sparing operation and medical interventional treatment for the management of tubal pregnancy. Methods A total of 63 patients with tubal pregnancy were randomly divided into two groups. One group underwent laparoscopic salpingotomy and aspiration of the gestational sac content , while the other group underwent intra-tubal injection of methotrexate （MTX）. Curative effects of the two procedures were compared. Results Laparoscopic oviduct-sparing operation was successfully performed on one session in 31 out of 32 patients, the success rate being 96.9%. Medical interventional treatment was conducted successfully in 24 out of 31 patients, 23 of whom received one dose of MTX and 1 of whom received two doses, the success rate being 77.4%. There was no statistical difference between the two groups in success rates （x^2 = 3. 765, P = 0. 052）. The time for serum β-hCG to normal levels was significantly shorter in patients receiving laparoscopic oviduct-sparing operation （9. 1 ± 2.1 d） than in patients receiving interventional treatment （26.3 ± 3.9 d） （t = - 20. 974, P = 0. 000）. Conclusions Both laparoscopic oviduct-sparing operation and medical interventional treatment can effectively preserve affected oviduct for patients with tubal pregnancy. As compared with medical interventional treatment, laparoscopic oviduct-sparing operation has a broader range of indications, less side effects, and a shorter recovery time of serum β-hCG.
出处
《中国微创外科杂志》
CSCD
2006年第4期266-267,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
输卵管妊娠
腹腔镜保守手术
介入治疗
Tubal pregnancy
Laparoscopic oviduct-sparing operation
Interventional treatment
