宫腔镜下输卵管插管注药治疗输卵管妊娠的近远期疗效观察

Short and long term efficacy of hysteroscopic tubal cannulation injection in treatment of tubal pregnancy

目的探讨宫腔镜下输卵管插管注药治疗输卵管妊娠的近远期临床效果。方法将本院妇产科就诊的未破裂输卵管妊娠患者123例,随机分为3组,A组41例采用宫腔镜下输卵管插管注入甲氨蝶呤,B组41例采用腹腔镜下输卵管开窗取胚术,C组41例采用甲氨蝶呤肌注口服米非司酮配合中药治疗。并比较各组的临床效果。结果临床疗效:A组与C组比较,P<0.05;A组与B组比较,P>0.05;B组与C组比较,P<0.05;血β-HCG水平:A组与B组比较,P>0.05;A组与C组比较,P<0.05;附件包块:A组与B组比较,P<0.05;A组与C组比较,P>0.05。输卵管通畅:A组与B组比较,P<0.05;A组与C组比较,P>0.05。结论在宫腔镜直视下患侧输卵管开口插管注入甲氨蝶呤治疗输卵管妊娠,疗效确切、安全,治疗时间短,毒副作用小,远期疗效好。另外,该治疗方法不留手术瘢痕,费用低,易被患者接受,是异位妊娠患者保守治疗的新途径。

Objective To explore the clinical effect of the injections in treatment of tubal pregnancy nearly forward hysteroscopic tubal cannulation. Methods The 123 unruptured tubal pregnancy patients were all from our hospital ob- stetrics and gynecology clinic, and they were randomly divided into three groups, 41 patients in group A were treated by the hysteroscopic tubal cannulation injection of methotrexate, 41 patients in group B were treated by the laparo- seopic tubal window Embryo surgery, 41 patients in group C were treated by the methotrexate intramuscular injection of oral mifepristone combined with Chinese medicine. And the clinical effect of each group were compared. Results The clinical efficacy was group A compared with group C, P 〈 0.05; Group A was compared with group B, P 〉 0.05; Group B was compared with group C, P 〈 0.05. Serum 13-HCG level was group A compared with group B, P 〉 0.05; Group A compared with group C, P 〈 0.05. The adnexal mass was group A compared with group B, P 〈0.05; Group A compared with group C, P 〉 0.05. The tubal patency was group A compared with group B, P 〈 0.05; Group A com- pared with group C, P 〉 0.05. Conclusion Opening intubation injection of methotrexate treatment of tubal pregnancy in hysteroscopy under direct vision ipsilateral tubal is efficacy and safety, treatment time is short, the side effects, the long-term efficacy. In addition, the treatment does not leave surgical scars, low-cost, easily patients, new avenues of conservative treatment of patients with ectopie pregnancy.