不同保守方法治疗异位妊娠临床观察

Clinical observation of different conservative treatments of ectopic pregnancy

目的探讨腹腔镜保守手术、药物治疗异位妊娠临床疗效和对生育功能的影响。方法 106例异位妊娠患者分为腹腔镜保守手术治疗组56例(腹腔镜组)与药物治疗组50例(药物组),比较2组治疗成功率、住院时间、血绒毛膜促性腺激素下降至正常的时间,治疗后双侧输卵管通畅情况、患侧输卵管妊娠率、重复异位妊娠率、宫内妊娠率及继发不孕率。结果腹腔镜组治疗成功率(100%)高于药物组(82%),住院时间((5.51±1.87)d)、血绒毛膜促性腺激素下降至正常时间((9.23±1.41)d)低于药物组((15.40±2.58)、(25.37±1.92)d),2组比较差异有统计学意义(P<0.05);2组双侧输卵管通畅率、患侧输卵管妊娠率、重复异位妊娠率、宫内妊娠率与继发不孕率比较差异无统计学意义(P>0.05)。结论腹腔镜手术治疗异位妊娠成功率高,对日后生育功能影响小。

Objective To explore the clinical therapeutic effect of laparoscopic conservative surgery and drug therapy on ectopie pregnancy and its function on fertility. Methods A total of 106 ectopic pregnancy patients were divided into laparoscopic conservative surgery group （surgery group, n= 56） and drug therapy group （drug group, n= 50）. Two groups were compared the success rate, the duration of hospitalization, the time of β-human chorionic gonadotropin （ft-hCG） decreasing to normal, bilateral tubal patency rate, pathological side tubal pregnancy rate, the recurrent ectopic pregnancy rate, the intrauterine pregnancy rate, and the secondary infertility rate. Results The success rate, the duration of hospitalization and the time of blood β-hCG decreasing to normal were 100 G, （5.51±1.87） days, （9.23± 1.41） days in surgery group, and 820/00, （15.40±2.58） days, （25.37±1.92） days in drug group, showing significant differences between two groups （P〈0.05）. The bilateral tubal patency rate, diseased tubal pregnancy rate, the recurrent ectopic pregnancy rate, the intrauterine pregnancy rate and the secondary infertility rate showed no significant differences between two groups （P〉0.05）. Conclusions Laparoscopic surgery treatment has a high success rate and little influence on fertility.