稳定型异位妊娠保守治疗的临床体会

Clinical experience of expectant treatment in stable ectopic pregnancy

目的探讨甲氨蝶呤(MTX)及腹腔镜保守性手术治疗稳定型异位妊娠的临床效果。方法对128例稳定型异位妊娠患者行保守治疗,MTX治疗58例,腹腔镜治疗70例,对2组患者治疗后血中人绒毛膜促性腺激素(β-HCG)下降情况、治疗成功率、输卵管通畅率进行比较。结果 MTX保守治疗异位妊娠成功率为86.2%,腹腔镜保守治疗成功率为97.1%,两组差异有统计学意义(P<0.05)。治疗后输卵管通畅试验随访,腹腔镜保守手术组通畅率为94.9%,明显高于MTX保守治疗组的63.6%,2组差异有统计学意义(P<0.01)。结论腹腔镜保守手术治疗异位妊娠可明显提高术后妊娠率,是稳定型异位妊娠治疗的首选方法。

[ Objective ] To explore the clinical effect of methotrexate （MTX } and laparoscopic surgery in treatment of stable ectopic pregnancy. [ Methods] 128 patients with stable eetopic pregnancy were treated with expectant treatment, MTX for 58 cases and laparoseopic surgery for 70 cases. The decrease of serum β-HCG, the success rate, and the tubal patency rate after treatment were compared between two groups. [ Results] The success rate of MTX and laparoscopic surgery in the treatment of ectopic pregnancy was 86.2% and 97.1% , and the difference was significant （P 〈0.05）. The patients were followed up after treatment to observe the tubal pateney, the tubal patency rate of the laparoscopic surgery （94.9% ） was higher than that of MTX （ 63.6%）, and the difference was significant （P 〈 0.01 ）. [ Conclusion] The laparoscopie surgery can significantly improve the postoperative pregnancy rate in patients with eetopic pregnancy, and it is the preferred method in the treatment of stable ectopic pregnancy.