腹腔镜术与药物治疗输卵管妊娠的临床对比观察

Clinical comparative observation of laparoscopic therapy and drug treatment for tubal pregnancy

目的观察输卵管妊娠在腹腔镜下保守手术LK局部甲氨蝶呤(MTX)治疗与单纯药物保守治疗的临床疗效。方法对108例行腹腔镜下保守手术的患者同时于术中向患侧输卵管局部注射甲氨喋呤(MTX)20mg,另对126例患者肌注氨甲喋呤加口服中药综合治疗,观察两组血β-HCG恢复到正常的时间及治疗2～6个月后输卵管的通畅情况。结果腹腔镜组血β-HCG值恢复到正常的时间(16.93±4.25)d,短于药物组(P<0.05),腹腔镜组患侧输卵管的通畅率达86.8%,高于药物组(P<0.05)。结论输卵管妊娠患者行腹腔镜下保守手术加局部甲氨喋呤药物治疗疗效优于单纯药物治疗。

Objective To observe the clinical effect of laparoscopic conservative therapy and methotrexate treatment or single drug treatment for tubal pregnancy.Methods 108 hospitalized cases （Laparoscope Group） with tubal pregnancy were treated with the conservative operation under laparoscope and injected with methotrexate 20mg in the tubal lesion,and 126 cases （Drug Group） were treated with single drug treatment（methotrexate and Chinese medicine）. Time of β-HCG level recovery and the tubal patency degree were observed in the 2 groups.Results The time of β-HCG recovery in the Laparoscope Group was （16.93±4.25）days,much shorter than that in the Drug Group （P0.05） and the patent rate of ovarian duct was 86.8%,much higher than that in the Drug Group （P0.05）.Conclusion Effect of the conservative operation therapy under laparoscope combined with methotrexate treatment is better than the single drug treatment.