摘要
目的探讨宫腔镜下插管注射MTX治疗输卵管妊娠的临床应用价值,寻求早期输卵管妊娠的最佳治疗手段.方法 2002年3月～2004年5月,采用前瞻性随机对照试验方法,将符合药物保守治疗条件的哪206例早期输卵管妊娠患者随机分为实验组102例,行宫腔镜下输卵管插管注射MTX治疗;对照组104例,行MTX-CF个体化减量方案治疗.比较两组治疗后血β-HCG及孕酮水平下降情况,血β-HCG恢复正常所需时间,治疗后包块变化及消失所需时间,药物副反应发生率,治疗效果,住院时间,医疗费用,月经恢复所需时间,MTX应用剂量及半年后的生殖功能情况.结果实验组较对照组治疗后血β-HCG及孕酮水平下降快(P＜0.05、P＜0.01),β-HCG恢复正常所需时间短(P＜0.05),包块短期增大程度小(P＜0.05),消化道反应、血白细胞下降、肝功能损害等药物副反应发生率低(P＜0.01、P＜0.01、P＜0.05).尤其是治愈率显著提高(P＜0.01),住院时间显著缩短(P＜0.01),MTX应用剂量显著减少(P＜0.01).其余观察指标无显著差异.结论宫腔镜直视下输卵管插管注射MTX治疗输卵管妊娠的局部给药方法,具有简便安全、高效无创、用药剂量小、药物副反应发生率低、住院时间短等诸多优点,有临床实际应用价值,是一种值得推广的早期输卵管妊娠理想治疗手段.
To study the clinical applied worth of methotrexate (MTX) injection by hysteroscopic catheterization in the treatment of tubal pregnancy, with the objective of finding out the best way to cure the early tubal pregnancy. The prospective randomized controlled trials were done during March 2002 to May 2004. 206 cases of the early tubal pregnancy according with the requirement of drug conservative treatment were randomized into two groups, a test group and a control group. 102 cases in the test group were treated by MTX injection under hysteroscopic tubal catheterization, while the other 104 cases (control group) were treated by individual MTX and leucovorin (CF)dose-reducing plan. After the treatment, the targets were compared in the two groups, including the β-HCG and progesterone (P) level falling in blood, the needed time in which β-HCG level in blood fell to normal one, the change of the mass, the needed time in which the mass disappeared, the incidence of drug side effects, the curative effects, the hospitalization time, the medical treatment expenses, the needed time in which the menstruation recovered, the dose of MTX administration and the reproductive ability after half a year. Compared with the targets after treatment in the control group,the test group was more benefit. β-HCG and P level in blood went down guicker (P<0.05, P<0.01), the needed time in which β-HCG in blood returned to its normal level was shorter (P<0.05), the extent of the mass enlarging temporarily was slighter (P<0.05), the incidence of drug side effects just as the reaction of digestive system, the dropping of white blood cell and the liver function harm were lower (P<0.01, P<0.01, P<0.05). Especially, the rate of cure increased markedly (P<0.01), the hospitalization time was shorter (P<0.01), the dose of MTX administration was much reduced(P<0.01). Other targets had no marked differences. [Conclusions] It has so many advantages Like conveniece and safty, hight efficiency, no wound, smaller drug dose, lower incidence of
出处
《中国内镜杂志》
CSCD
北大核心
2005年第2期165-169,共5页
China Journal of Endoscopy
关键词
宫腔镜
插管
甲氨蝶呤
输卵管妊娠
hysteroscopy
catheterization
methorexate
tubal pregnancy
