腹腔镜保守手术联合药物防治输卵管妊娠后持续性异位妊娠的临床研究

Clinical research of laparoscopic conservative operation combined with medication in prevention and treatment of persistent ectopic pregnancy after tubal pregnancy

目的:探讨米非司酮联合甲氨蝶呤用于防治输卵管妊娠腹腔镜保守手术后持续性异位妊娠(persistent ectopic pregnancy,PEP)的疗效。方法:为87例输卵管妊娠患者行腹腔镜保守手术,术前应用米非司酮50mg,2次/d,取出妊娠物后继续口服米非司酮50mg,2次/d,肌注甲氨蝶呤20mg,1次/d。结果:87例手术均获成功,术后无一例发生PEP。结论:术前用米非司酮,术后米非司酮联合甲氨蝶呤能预防输卵管妊娠腹腔镜保守手术后PEP的发生,患者痛苦少,无明显不良反应,具有临床应用价值。

Objective：To investigate the therapeutic efficacy of Mifepristone combined with Methotrexate in prevention and treatment of persistent ectopic pregnancy （PEP） after laparoscopic conservative operation for tubal pregnancy. Methods： Laparoscopic conservative operation was performed in 87 patients suffering tubal pregnancy. Before operation,they accepted 50mg Mifepristone bid. After the embryo was removed, 50mg Mifepristone bid po and 20rag Methotrexate qd im was given. Results： Eighty-seven operations were successful, no PEP was found after surgery. Conclusions ： Preoperative administration of Mifepristone and postoperative administration of Mifepristone combined with Methotrexate can prevent PEP after laparoscopic conservative operation for tubal pregnancy, reduce pain of patients without obvious adverse effect and is of clinical application value.