小剂量甲氨蝶呤联合腹腔镜保守手术治疗异位妊娠的疗效

Therapeutic efficacy of small dosage of Methotrexate( MTX) combined with laparoscopic conservative Surgery in the treatment of ectopic pregnancy

目的:探讨小剂量甲氨蝶呤(MTX)联合腹腔镜保守手术治疗异位妊娠的疗效。方法:选择80例异位妊娠患者,随机分为实验组和对照组。两组患者均接受腹腔镜保守手术治疗,实验组加用术中MTX局部注射治疗。结果:实验组患者手术时间、术中出血量、住院时间、术后β-HCG降至正常时间均少于对照组(P<0.05或P<0.01)。实验组患者PEP发生率及2年内再发异位妊娠率均低于对照组(χ2=4.51、4.50,P<0.05),且半年内输卵管再通率及2年内宫腔内正常妊娠率均高于对照组(χ2=4.11,4.94,P<0.05)。结论:采用小剂量甲氨蝶呤联合腹腔镜保守手术治疗异位妊娠较单纯手术治疗能取得更好的疗效,再次宫内妊娠率高,且术后PEP及再次异位妊娠发生率低,具有良好的临床疗效。

Objectives： To explore the therapeutic effect of small dosage of Methotrexate （MTX） combined with laparoscopic conservative surgery on the treatment of ectopic pregnancy. Method： Eighty patients with ectopic pregnancy were selected and randomly divided into the experimental group and the control group. Both groups received laparoscopic conservative surgery, while the patients in the experimental group were given extra MTX local injection. Results： Tile experiment group showed better effects than the control group in terms of the operation time, intraoperative amount of bleeding, length of stay （LOS） , and the time for β -HCG declining to normal after operation （ P 〈 0. 05 or P 〈 0. 01 ）. The occurrence rates of PEP and a second ectopic pregnancy within 2 years were both lower than the rates in the control group （X2 = 4. 51,4.50, P 〈 0.05. The occurrence of side fallopian tube recanalization after half a year and the normal pregnancy in the womb within 2 years in the experimental group were also higher than those in the control group （X2 = 4. 11,4. 94, P 〈 0. 05 ）. Conclusion ： Compared with the simple operation treatment, small dosage of Methotrexate （MTX） combined with laparoscopic conservative surgery can achieve better therapeutic effect on ectopic pregnancy. The combined treatment can lead to higher rate of womb pregnancy, low occurrence rates of postoperative PEP and a second ectopic pregnancy.