摘要
目的探讨输卵管妊娠行腹腔镜保守手术中使用甲氨喋呤(MTX)预防持续性异位妊娠的临床价值。方法对68例确诊为输卵管壶腹部妊娠的患者行腹腔镜开窗取胚术,将患者随机分为2组实验组(n=34)术中局部应用MTX20mg,对照组(n=34)局部注射等容量的生理盐水。于术前和术后d1、d4、d7、d10、d14查β-HCG及观察临床表现。结果2组术前一般情况和血β-HCG水平差异无显著性,但术后d1差异有显著性(P<0.05),术后d4、d7(P<0.01)和d10、d14(P<0.00)差异有极显著性。实验组无术后持续性异位妊娠(PEP),对照组出现6例术后PEP,二者差异有显著性(P<0.05)。结论在异位妊娠腹腔镜开窗取胚术中局部应用MTX可预防术后PEP的发生。
Objective:To study the clinical effect of intraoperative local methotrexate in laparoscopic salpingostomy.Methods:Sixty-eight patients diagnozed as ampulla tubal pregnancy were subjected to laparoscopic salpingostomy.They were radomized into two groups: in the experimental group (n=31), methotrexate (MTX) 20 mg was locally injected;and in the control group (n=37) the same volume of saline was used.Serume β-HCG was examined preoperatively and in postoperative 1, 4, 7, 10, 14 d,and the clinical manifestation was observed.Results:There was no significant difference between the two groups in preoperative general data and β-HCG levels.Postoperative β-HCG levels were obviously different between the two groups in postoperative 1 d, and became more significantly different at the postoperative 4, 7, 10 and 14 d.No patient in the experimental group developed persistent ectopic pregnancy (PEP) but 6 patients in the control group did, which was significantly different.Conclusion:Local use of MTX was effective in the prevention of PEP in laparoscopic salpingostomy.
关键词
输卵管妊娠
MTX
腹腔镜
持续性异位妊娠
Ampulla tubal pregnancy
MTX
Laparoscope
Persistant ectopic pregnancy
