摘要
目的探讨术前辅助甲氨蝶呤配合腹腔镜保守手术治疗输卵管妊娠的疗效及临床价值。方法分析76例有生育要求、行腹腔镜保守手术治疗的输卵管妊娠患者的临床资料,其中术前应用甲氨蝶呤配合保留输卵管的腹腔镜手术治疗40例(研究组),行腹腔镜保留输卵管手术并术中局部注射甲氨蝶呤治疗36例(对照组),比较2组患者手术时间、术中出血、术后血血清人绒毛膜促性腺激素(HCG)下降、持续性异位妊娠发生率及术后输卵管通液的情况。结果所有患者均成功实施保留患侧输卵管的腹腔镜手术,无中转开腹病例;研究组手术时间短、术中出血少、术后输卵管通畅率高,与对照组比较差异有统计学意义(P<0.05),术后血HCG降至正常天数2组差异无统计学意义(P>0.05)。2组均未有持续性异位妊娠发生。结论甲氨蝶呤配合保守性腹腔镜手术治疗输卵管妊娠不仅能减少术中出血,有效预防持续性异位妊娠的发生,确保手术的成功率及安全性,还能提高术后输卵管复通的几率,对改善患者术后的生育功能具有积极的临床意义。
Objective To explore the clinical value for treatment tubal pregnancy by using methotrexate （MTX） before laparoscopic conservative surgery. Methods 76 patients who were diagnosed tubal pregnancy and performed conservative laparoscopic surgery were analyzed in recent 3 years. There 40 patients （experimental group） were injected MTX before surgery,36 patients （control group） accepted operation only, and time of operation, blood loss, serum HCG after operation, incidence of persistent eetopic pregnancy （PEP） and postoperative tubal patency rate were compared between the two groups. Results All the surgery were successfully completed, there was no conversion to laparostomy. Experimental group used less time,less blood loss, and got higher tubal patency rate than those in con- trol group （ P 〈 0.05 ） , there were no significant difference as to incidence of persistent ectopic pregnancy （PEP） between the two groups. Conclusion Preoperative using MTX can not only ensure safety of the conservative laparoscopic operation, but also improve postoperative tubal patency rate, which is of great value to ameliorate fertility of patients with tubal pregnancy after surgery.
出处
《宁夏医学杂志》
CAS
2013年第9期838-839,共2页
Ningxia Medical Journal
关键词
甲氨蝶呤
输卵管妊娠
腹腔镜保守性手术
Methotrexate
Tubal pregnancy
Conservative laparoscopic surgery
