甲氨蝶呤与腹腔镜手术保守治疗输卵管妊娠后再妊娠结局比较

Analysis of methotrexate and laparoscopic surgery conservative treatment of tubal pregnancy repregnancy outcome

目的比较甲氨喋呤与腹腔镜手术保守治疗输卵管妊娠对患者再次妊娠结局的影响。方法对确诊为输卵管妊娠、有生育要求且未生育过的96例患者的临床资料进行回顾性分析。依据不同治疗方法分为甲氨蝶呤组46例和腹腔镜组50例。比较两组术后宫内妊娠、再次异位妊娠和继发不孕情况。结果腹腔镜组宫内妊娠率为70．0％，明显高于甲氨蝶呤组的47．8％（χ2=13．229，P〈0．05）；腹腔镜组再次异位妊娠率为14．0％，与甲氨蝶呤组的17．4％差异无统计学意义（χ2=2．037，P〉0．05）；甲氨蝶呤组继发不孕率为34．8％，显著高于腹腔镜组的16．0％（χ2=12．784，P〈0．05）。结论腹腔镜手术保守治疗输卵管妊娠后再妊娠结局优于甲氨蝶呤。

Objective To compare the effect of methotrexate combined with laparoscopic surgery on pregnancy outcome of patients with tubal pregnancy treated with conservative treatment . Methods 96 patients who were diag- nosed of tubal pregnancy, fertility requirements and no clinical data given birth were analyzed retrospectively. Depending on the method of treatment was divided into 46 cases of methotrexate and laparoscopic group of 50 patients. Postoperative intrauterine pregnancy, ectopic pregnancy and secondary infertility situation again Were com- pared. Results Laparoscopic group in intrauterine pregnancy rate was 70.0%, which was significantly higher than that in the methotrexate group （47.8%）, and the difference was statistically significant（ χ2 = 13. 229 ,P 〈 0.05 ） ;lap- aroscopic ectopic pregnancy rate was 14.0% against 17.4% with methotrexate group , the difference was not statisti- cally significant（ χ2 = 2. 037, P 〉 0.05 ） ; methotrexate group was 34. 8% of secondary infertility was significantly higher than that in the laparoscopic group （ 16.0% ）, the difference was statistically significant （ χ2 = 12. 784, P 〈 0. 05）. Conclusion Laparoscopic surgery after conservative treatment of tubal repregnancy outcome is better than methotrexate.