宫腔镜下输卵管插管注射甲氨蝶呤治疗输卵管妊娠的临床研究

Clinical research of hysteroscopic tubal cannulation methotrexate injection for tubal pregnancy

目的:探讨通过宫腔镜引导下输卵管插管注射甲氨喋呤(MTX)联合口服米非司酮的给药途径治疗早期未破裂型输卵管妊娠的临床治疗效果。方法:选择住院治疗的78例未破裂型输卵管妊娠患者,按自愿的原则,对其中40例(甲组)采用宫腔镜下输卵管插管单次注射MTX 50mg联合口服米非司酮,38例(乙组)采用MTX 20 mg每日1次肌注,连用3天,联合口服米非司酮,两组米非司酮的口服方法相同。对治疗前1天和治疗后3天、7天、14天的关键性指标进行统计学分析。结果:在两组的年龄、孕次、孕龄、宫旁包块大小、血β-hCG值均有可比性的情况下,甲组成功36例,成功率90.00%。乙组成功33例,成功率86.84%,两组治疗成功率比较,差异有统计学意义(P<0.05)。结论:宫腔镜引导下输卵管注射MTX与口服米非司酮联合治疗未破裂型输卵管妊娠较全身治疗效果好,可安全有效地治疗早期未破裂型输卵管妊娠。

Objective ： To explore the clinical effect of the injection of methotrexate guided through hysteroscopic tubal cannulation combined oral route of administration of mifepristone treatment of early unruptured tubal pregnancy. Methods： 78 hospitalized cases of un- ruptured tubal pregnancy were collected, voluntary hysteroscopic tubal cannulation single injection of MTX 50 mg in combination with oral mifepristone to 40 patients （Group A）, 38 patients （Group B） with MTX 20 mg daily intramuscular injection once every three days in com- bination with oral mifepristone, two groups of mifepristone orally in the same way. 1 day before treatment and after treatment 3 days, 7 days, 14 days, the key index were statistically analyzed. Results： The age, gravidity, gestational age, uterine size of mass, serum ~ - HCG values were comparable in the two groups, Group A 40 cases, 36 eases of success, the success rate of 90%. Group B 38 cases, 33 cases of success, the success rate of 87%, treatment success rates of the two groups were significant different （P 〈 0.05 ） . Conclusion： Endo： scopic guided tubal injection of MTX combination therapy of oral mifepristone unruptured tubal pregnancy has less systemic treatmenteffect can be safe and effective in the treatment of early unruptured tubal pregnancy.