甲氨喋呤预防持续性异位妊娠的临床分析

Effects of methotrexate for preventing persistent ectopic pregnancy

目的:分析研究甲氨喋呤预防持续性异位妊娠的临床疗效。方法:将204例经腹腔镜保守手术治疗患者随机分为A组、B组各102例。A组采用甲氨喋呤10mg、B组采用甲氨喋呤20mg均残腔部位注射进行治疗。统计分析甲氨喋呤对持续性异位妊娠发病的预防效果。结果:204例患者中,有5例(2.45%)发生持续性异位妊娠。其中,A组3例(2.94%);B组2例(1.96%),两者比较差异无统计学意义(P>0.05)。不良反应发生率为2.45%,其中,A组4例(3.92%),B组1例(0.98%),两者比较差异有统计学意义(P<0.05)。5例PEP患者术后1d、3d、12d血清β-HCG的下降率与199例非PEP患者相比差异均有统计学意义(P<0.05)。术后1d、3d,B组非PEP患者的β-HCG下降率与A组相比差异无统计学意义(P>0.05);术后12d,B组非PEP患者的β-HCG下降率与A组相比差异有统计学意义(P<0.05)。结论:采用MTX病灶残腔部位注射能有效预防PEP发生,使血清β-HCG的下降明显且速度快,毒副反应少,缩短住院时间,从而降低二次手术的可能,临床值得推广。

To discuss the clinical efficacy of methotrexate for preventing persistent ectopic pregnancy. Methods：204 cases scheduled for laparoscopic surgery were randomly divided into group A and group B, with102 cases in each group. Group A was given 10 nag of naethotrexate for residual cavity injection while group B was received 20 nag of naethotrexate, the clinical efficacy of naethotrexate for preventing persistent ectopic pregnancy were observed. Results：Five patients （2.45 %） had persistent ectopic pregnancy, of which 3 cases （2.94%） were in group A~ nificant difference between the two groups （P〉0.05）. and 2 （l. 96%） were in group B, showing no sig- The incidence of side effect was 2.45 %, of which3.92% （4 cases） was in group A and 0.98% was in group B, there was significant difference between the two groups （P〈0.05）. The decrease in serumβ-HCG level 1, 3 and 12 d after the surgery for the 5 PEP cases were significantly different from the other 199 cases （P%0.05）. Decrease in serumβ-HCG 1 d and 3 dafter the surgery for cured patients in group B was not significant different from cured patients in group A, but 12 days after the surgery, the difference was significant （P〈0.05）. Oonclusions. Residual cavity injection of methotrexate can effectively prevent the reoccurrence of PEP; it makes serum β-HCG decrease significantly without inducing severe toxicity, shortens hospitalization time, reduces the possibility of secondary surgery, and it＇s worth for application in large scale.