治疗输卵管妊娠2种术式结合MTX临床疗效的比较

Compare Two Kinds Surgical Treatment of Tubal Pregnancy Combined with MTX Efficacy

目的针对开腹手术结合MTX药物与腹腔镜下开窗取胚胎保输卵管结合MTX药物两种方法治疗输卵管妊娠临床疗效的探讨。方法随机挑选从2007年3月至2012年11月来我院治疗输卵管妊娠的患者388例为参考对象。根据行术方式的不同将其分为观察组和对照组,行腹腔镜手术患者为观察组,患者数为198例;行开腹手术患者为对照组,患者数为190例。观察组患者年龄段为19~42岁,其中经产妇68例,初产妇130例,有35例有人流史,怀孕周期32~42周;开腹组年龄20~40岁,其中经产妇49例,初产妇141例,有42人例有人流史,怀孕周期31~42周。两组患者的文化水平、孕周、年龄、停经时间等各项身体指标均无明显差异,具有可比性,无统计学意义（P〉0.05）。结果观察组患者术中出血量小于对照组,手术时间短于对照组,术后肛门排气时间、康复周期、手术创口大小等方面的差异明显,有统计学意义,P〈0.05。结论采用腹腔镜手术治疗输卵管妊娠较开腹手术更为有效。其手术成功率高,对患者的身体伤害少,是值得推广的行之有效的治疗方式。

Objective To explore the value of laparotomy with MTX and laparoscopic surgery with MTX of tubal pregnancy. Methods 198 cases of tubal pregnancy treated by laparoscopic surgery with MTX were reviewed retrospectively. 190 cases of laparo-tomy with MTX were retrospectively analyzed by reviewing medical literature. We selected 388 patients treated in our hospital from March, 2007 to November, 2012. We divided them into observation group and control group. There are 198 patients in the observation group, 190 patients in the control group. There were no significant difference between the physical indexes of two groups, such as cultural level, gestational age, age, amenorrhea time.The difference between both groups was not significant at all days. Results The difference of hemorrhagic in operation was also significant, the amount of bleeding in the observation group is lesser than control group. Physical recovery of two groups also has significant differences. Conclusions People with tubal pregnancy should choose laparoscopy with MTX, because laparoscopy in treatment of tubal pregnancy is more efficiently, and laparoscopic surgery becomes main therapeutic tool for these patients in our hospital.