腹腔镜下输卵管切开取胚加局部MTX注射与药物保守治疗输卵管妊娠后再次妊娠分析

Analysis on re-pregnancy after treatment of tubal pregnancy with salpingotomy and embryo collection under laparoscope plus local MTX injection and drug conservative treatment

目的探讨两种保守性治疗方法治疗输卵管妊娠后再次妊娠情况。方法回顾性分析2005-03—2008-03该院采用保守性治疗方法治疗的125例未生育输卯管妊娠患者的临床资料，根据治疗方法不同，分为腹腔镜下输卵管切开取胚加局部甲氨蝶呤（MTX）注射65例（A组）和药物保守治疗60例（B组）。比较两组术后宫内妊娠、再次异位妊娠及继发不孕的情况。结果A组宫内妊娠发生率高于B组（P〈0．05），继发不孕发生率低于B组（P〈0．05），而两组再次异位妊娠发生率比较差异无统计学意义（P〉0．05）。结论腹腔镜下输卵管切开取胚加局部MTX注射治疗未生育输卵管妊娠患者优于药物保守治疗。

Objective To discuss the re-pregnancy after the treatment of tubal pregnancy with two conserva- tive methods. Methods A retrospective analysis was conducted on clinical data of 125 nulliparous patients of tubal pregnancy treated with conservative methods in our hospital from March 2005 to March 2008. According to different methods, they were divided into two groups, group A, including 65 patients with salpingotomy and embryo collection under laparoseope plus local MTX injection, and group B, including 60 patients with drug conservative treatment. Two groups were compared in postoperative uterine pregnancy, ectopie pregnancy again and secondary infertility. Re- sults The incidence of uterine pregnancy in group A was higher than that in group B （P 〈 0.05 ） and the incidence of sceondry infertility in group A was lower than that in group B（P 〈0.05） ,but there was no statistically significant difference in incidence of ectopic pregnancy again between two groups （ P 〉 0. 05 ）. Conclusion The treatment of nulliparous patients of tubal pregnancy with salpingotomy and embryo collection under laparoscope plus local MTX in- jection is better than drug conservative treatment.