腹腔镜输卵管妊娠保守手术及手术加用药物的疗效比较

Conservative Operation of Tubal Pregnancy under Celioscope and Companion with Methotrexate

目的：比较单用腹腔镜输卵管妊娠保守手术及手术加在患侧输卵管系膜内注射氨甲喋呤两者的疗效。方法：把65例腹腔镜下输卵管妊娠保守手术的患者分为两组。A组单行腹腔镜下输卵管妊娠产物清除术；B组手术同时于输卵管系膜内注射氨甲喋呤30mg。术后随访监测血β-HCG下降水平。结果：A组治愈率87．10%,B组治愈率100%(P＜0．05)；A组血β-HCG下降至正常水平时间为13．5±1．86d,B组下降至正常为9．0±1．01d(P＜0．05)。结论：腹腔镜下输卵管妊娠产物清除术并在输卵管系膜内注射氨甲喋呤30mg比单行妊娠产物清除术的疗效显著好,并降低持续性宫外孕发生率。

Objective,To discuss the clinical feasibility and effect about the conservative treatment of tubal pregnancy under ce lioscope with the help of methotrexate injection in mesosalpinx, find a better treatment method of preventing the patient fromp ersistent ectopic pregnancy. Methods：65 tubal pregnancy patients who were treated conservatively under celioscope are separated to 2 groups. 31 patients in Group A had simply the tubal pregnancy product eliminating operation under celioscope; 34 pa tients in Group B had both the tubal pregnancy product eliminating operation under celioscope and the injection of MTX 30mg in mesosalpinx simultaneously. The decreasing level （titer） of serum β-HCG was monitored and measured after operation. Results： Before the operaion, the differences of the general data, the serum β-HCG levels and tubal diameters at the focus of the 2 groups （P〉0.05）did not have any obvious meaning. The cure rate and the time for the serum β-HCG decreased to normal level of the 2 groups were as followings： Group A 87. 10% and 13.5 ± 1.86 days; Group B 100% and 9. 0 ± 1.01 days. Group B had the better effect than Group A. This difference had very obvious and important meaning（P〈20. 05 ）. Concision：The conservative treatment of tubal pregnancy under celioscope with the help of injection of methotrexate （MTX） in mesosalpinx has great clinical feasibility and effect. This is a better solution, when we do the tubal pregnancy product eliminating operation plus the injection of MTX 30mg in mesosalpinx under celioscope. It can prevent the patient from happening of persistent ectopic pregnancy effectively.