摘要
目的研究在异位妊娠(EP)治疗中予以输卵管开窗取胚术结合不同剂量甲氨蝶呤(MTX)治疗的临床效果。方法选择2018年7月—2021年10月中国人民解放军陆军第七十一集团军医院收治的EP患者68例为研究对象,应用随机数字表法将其分为两组,使用输卵管开窗取胚术+小剂量MTX的34例患者纳入对照组,使用输卵管开窗取胚术+中等剂量MTX的34例患者纳入观察组。对比两种治疗方案下患者的预后指标、输卵管畅通情况、血清学指标及不良反应发生率。结果观察组术后3、7、14 d的人绒毛膜促性腺激素-β(β-hCG)水平为(422.28±67.24)、(326.55±34.26)、(108.33±14.20)mIU/mL,均低于对照组的(495.55±70.45)、(392.47±39.45)、(169.42±17.45)mIU/mL,差异有统计学意义(t=4.207、7.357、15.833,P<0.05),观察组β-hCG恢复正常及阴道停止出血时间均短于对照组,差异有统计学意义(t=6.717、3.682,P<0.05)。观察组输卵管畅通率为100.00%,高于对照组的82.35%,差异有统计学意义(χ^(2)=4.570,P<0.05)。观察组血清学指标血清磷酸肌酸激酶(CK)、孕酮(P)及妊娠相关血浆蛋白A(PAPP-A)水平为(61.25±10.46)U/L、(2.92±0.66)ng/mL、(3.02±0.25)mU/L,均低于对照组的(80.55±11.23)U/L、(4.15±0.46)ng/mL、(3.36±0.42)mU/L,差异有统计学意义(t=7.333、8.915、4.056,P<0.05)。观察组不良反应发生率(8.82%)低于对照组(29.41%),差异有统计学意义(χ^(2)=4.660,P<0.05)。结论在EP治疗中予以输卵管开窗取胚术+中等剂量MTX治疗较小剂量用药效果更为显著,且安全性高。
Objective To study the clinical effect of tubal fenestration combined with different doses of methotrexate(MTX)in the treatment of ectopic pregnancy(EP).Methods A total of 68 EP patients admitted to 71st Army Group Military Hospital of the Chinese People's Liberation Army from July 2018 to October 2021 were selected as the re⁃search objects,and divided into two groups by random number table method.34 patients who used tubal fenestration+low-dose MTX were included in the control group,and 34 patients who used tubal fenestration+medium-dose MTX were included in the observation group.The prognostic indicators,tubal patency,serological indicators and in⁃cidence of adverse reactions were compared between the two treatment regimens.Results The levels of human chori⁃onic gonadotropin-β(β-hCG)in the observation group on 3 d,7 d and 14 d after operation were(422.28±67.24)mIU/mL,(326.55±34.26)mIU/mL,(108.33±14.20)mIU/mL,all lower than the control group(495.55±70.45)mIU/mL,(392.47±39.45)mIU/mL,(169.42±17.45)mIU/mL,the difference was statistically significant(t=4.207,7.357,15.833,P<0.05).The time whenβ-hCG returned to normal and vaginal bleeding stopped in the observation group was shorter than that in the control group,and the difference was statistically significant(t=6.717,3.682,P<0.05).The patency rate of fallopian tubes in the observation group was 100.00%,which was higher than 82.35%in the con⁃trol group,and the difference was statistically significant(χ^(2)=4.570,P<0.05).Serum levels of serum creatine kinase(CK),progesterone(P)and pregnancy-related plasma protein A(PAPP-A)in observation group were(61.25±10.46)U/L,(2.92±0.66)ng/mL,(3.02±0.25)mU/L,which were all lower than(80.55±11.23)U/L,(4.15±0.46)ng/mL,and(3.36±0.42)mU/L of the control group,and the differences were statistically significant(t=7.333,8.915,4.056,P<0.05).The incidence of adverse reactions in the observation group(8.82%)was lower than that in the control group(29.41%),and the difference was statistically significant(χ^(2)=4.660,
作者
刘颖
LIU Ying(Department of Obstetrics and Gynecology,71st Army Group Military Hospital of the Chinese People's Liberation Army,Xuzhou,Jiangsu Province,221004 China)
出处
《系统医学》
2022年第11期157-160,共4页
Systems Medicine
