摘要
目的研究甲氨蝶呤(Methotrexate,MTX)局部注射联合腹腔镜开窗取胚术对异位妊娠患者再次妊娠及血清β-HCG的影响。方法按简单随机化法将2017年3月至2018年12月间108例异位妊娠患者进行分组各54例,对照组行腹腔镜开窗取胚术治疗,观察组增加MTX局部注射治疗,比较两组术后恢复情况、血清β-HCG水平、输卵管通畅情况及再次妊娠情况。结果观察组包括块消失时间、月经恢复正常时间及血清β-HCG恢复正常时间均较对照组短(P<0.05);观察组术后1d、术后7d血清β-HCG水平下降幅度较对照组明显(P<0.05);观察组的通畅率为72.22%较对照组35.18%高(P<0.05);观察组正常宫内妊娠81.48%较对照组61.11%高(P<0.05)。观察组再次异位妊娠发生率为5.56%,低于对照组的18.52%(P<0.05)。结论MTX联合腹腔镜开窗取胚治疗异位妊娠患者能通过抑制滋养细胞增生,改善患者血清β-HCG水平,促进术后恢复,提高输卵管通畅率和妊娠率。
Objective To study the effects of local methotrexate(MTX)injection combined with laparoscopic fenestration on re-pregnancy and on the expression of serum β-HCG in patients with ectopic pregnancy.Methods According to the simple randomization method,108 patients with ectopic pregnancy from March 2017 to December 2018 were selected and divided into two groups with 54 cases in each group.The control group was treated with laparoscopic windowing and embryo removal.The observation group was treated with MTX local injection on the basis of the control group.Postoperative recovery,serum β-HCG levels,tubal patency,and re-pregnancy were compared between the two groups.Results The time of mass disappearance,menstrual return to normal time,and serum β-HCG return to normal time in observation group were shorter than those in the control group(P<0.05).The the serum β-HCG levels of the observation group decreased on day 1 and day 7 after the operation.Compared with the control group(P<0.05),the patency rate in the observation group was 72.22%,which was higher than that in the control group(72.22% vs.35.18%,P<0.05);the normal intrauterine pregnancy in the observation group was 81.48%,which was higher than that in the control group(81.48% vs.61.11%,P<0.05).The incidence of re-ectopic pregnancy in the observation group was 5.56%,which was lower than 18.52% in the control group(P<0.05).Conclusion MTX combined with laparoscopic fenestration can treat ectopic pregnancy patients by inhibiting trophoblast proliferation,improving patients'serum β-HCG levels,promoting postoperative recovery,and increasing tubal patency and pregnancy rates.
作者
赵睿超
罗国臣
ZHAO Rui-chao(Department of Obstetrics and Gynecology,Jun County People's Hospital Xunxian 456250,China)
出处
《牡丹江医学院学报》
2020年第4期76-78,共3页
Journal of Mudanjiang Medical University
