输卵管妊娠保守治疗106例分析

Conservative Treatment of Tubal Pregnancy:An Analysis of 106 Cases

目的分析并评价腹腔镜保守性手术治疗与药物治疗输卵管妊娠的临床效果。方法对有生育要求的106例输卵管妊娠,45例患者实施单次肌肉注射甲氨蝶呤(药物治疗组),61例实施腹腔镜保守性手术治疗(手术治疗组)。结果手术治疗组平均治疗时间为(9±4)d,成功率为100%,治疗后输卵管通畅率为91.80%,宫内妊娠率为68.85%;药物治疗组平均治疗时间为(21±7)d,成功率为86.67%,治疗后输卵管通畅率为61.54%,宫内妊娠率为41.03%;两组间比较有显著性差异(P<0.05)。两组再次异位妊娠发生率比较无显著性差异(P>0.05)。结论药物治疗和手术治疗均有较高的成功率,但两组比较腹腔镜下保守性手术治疗有明显优势。

Objective To analyze and assess the clinical results of conservative operation and medicinal therapy for tubal pregnancy（TP）. Methods Of 106 cases with TP requirement ,45 cases were treated with single muscular injection of methotrexate（MTX） （medicinal therapy group）and 61 cases were treated with laparoscopie conservative operation（ operation group）. Results In operation group, mean treatment time was（9 ±4） days and successful rate was 100% ; after treatment,the rate of tubal patency was 91.80% and the rate of intrauterine pregnancy was 68.85%. In medicinal therapy group, mean treatment time was （21 ± 7 ） days and successful rate was 86.67% ;after treatment,the rate of tubal patency was 61.54% and the rate of intrauterine pregnancy was 41.03 ,which presented significant difference in group comparison（ P 〈 0.05 ）. The difference was not statistically significant in the recurrence of ectopic pregnancy in group comparison（ P 〉 0.05 ）. Conclusion Either medicinal therapy and operation can achieve quite high successful rate, but laparoscopic conservative operation demonstrates apparent advantages in group comparison.