腹腔镜手术中米非司酮联合MTX预防输卵管妊娠后持续性异位妊娠临床疗效和安全性

Clinical efficacy and safety of mifepristone combined with MTX during laparoscopic surgery in prevention of persistent ectopic pregnancy after tubal ectopic pregnancy

目的：为了寻求更好的预防输卵管妊娠后持续性异位妊娠临床治疗效果，分析和探讨在进行腹腔镜手术治疗过程中米非司酮联合甲氨蝶呤（MTX）的可行性和必要性。方法：选取120例于2009年1月～2013年12月期间在该院妇科住院治疗的输卵管妊娠患者作为研究对象，将其分为对照组（60例）和观察组（60例），其中对照组患者单纯采取腹腔镜手术治疗，观察组患者在采取腹腔镜手术治疗的同时应用米非司酮联合MTX治疗，对比和分析两组患者治疗效果和术后患者血中β—HCG的影响。结果：观察组患者的临床治疗效果和对照组患者比较差异具有统计学意义（P〈0．05）；而观察组患者术后2周血β—HCG降低的程度和对照组患者相比显著占优势。差异具有统计学意义（P〈0．05）。结论：输卵管妊娠患者在进行腹腔镜手术治疗的过程中应用米非司酮联合MTX治疗，不仅可以提高患者的治疗效果，而且有利于降低血中β—HCG。

Objective： To find better clinical efficacy in prevention of persistent ectopic pregnancy after tubal ectopic pregnancy, analyze and explore the feasibility and necessity of mifepristone combined with methotrexate （MTX） during laparoscopic surgery. Methods： One - hundred patients diagnosed as tubal ectopic pregnancy treated in the hospital from January 2012 to December 2013 were selected as the study objects, then they were divided into control group and observation group, 60 patients in each group ; the patients in control group were treated with laparoscopic surgery, and the patients in observation group were treated with laparoscopic surgery, mifepristone combined with MTX ; the curative effects and the effects of blood β - hCG after surgery in the two groups were compared and analyzed. Results ： There was statistically significant difference in clinical curative effect between the two groups （ P 〈 0. 05 ） ; the decreasing degree of blood β- hCG at two weeks after surgery in observation group was statistically significantly higher than that in control group （P 〈 0. 05 ） . Conclusion： Mifepristone combined with MTX during laparoscopic surgery for patients with tubal ectopic pregnancy not only can improve curative effect, but also can reduce blood β -hCG level.