腹腔镜保留输卵管术后口服甲氨蝶呤预防持续性输卵管妊娠的疗效

Effect of Oral Methotrexate on Prevention of Persistent Ectopic Pregnancy After Laparoscopic Surgery with Fallopian Tube Retention

目的:探讨腹腔镜保留输卵管术后口服甲氨蝶呤预防持续性宫外孕的疗效。方法:选用150例宫外孕保守手术术后伴高危因素的患者分为3组:A组50例,口服甲氨蝶呤50mg/m2,2h1次,12次为一疗程;术后24h开始服用;B组50例,米非司酮100mg,2次/d共5d,术后24h开始服用;C组为对照组50例,保守性手术后未预防用药。治疗后常规监测。结果:A组未发生PEP,B组发生持续性宫外孕7例,发生率16%,C组%持续性宫外孕9例,发生率18%。两预防组低于非预防组的18%,A组与C组相比P<0.05,有显著性差异;B组与C组相比P>0.05,无显著性差异;3组无严重的副反应。结论:口服甲氨蝶呤能有效预防保留输卵管术后持续性宫外孕。

Objective： To observe the clinical effect of Methotrexate（MTX） tablets on persistent ectopic pregnancy （PEP） after laparoscopic surgery with fallopian tube retention. Methods. A total of 150 cases of ectopic pregnancy underwent laparoscopy operation were randomly divided into MTX prevention group, Mifepristone prevention group, and non-prevention group （control group）, with 50 cases in each group. Results. There was no PEP case in MTX group after treatment, while 7 and 9 cases of PEP respectively were found in Mifepristone group and control group. The incidence of PEP was significantly decreased after MTX prevention （P〈0.05）. There are no se- rious adverse reactions in all the three groups. Conclusion. It is effective to prevent PEP with oral administration of MTX for post-laparoscopic ectopic pregnancy patients.