输卵管插管联合肌肉注射甲氨喋呤治疗异位妊娠的临床疗效观察

Clinical observation on intubation of oviduct and muscle injection of methotrexate in the treatment of ectopic pregnancy

目的了解输卵管插管联合全身注射甲氨喋呤治疗异位妊娠的临床效果。方法选取2011年7月—2013年7月本院收治的96例异位妊娠患者,随机分为对照A组(采用米非司酮口服治疗,32例)、对照B组(采用甲氨蝶呤肌肉注射治疗,29例)和观察组(采用输卵管插管联合肌肉注射甲氨喋呤治疗,35例)。3组在年龄、停经时间、包块直径、治疗前血HCG值等方面的分布基本一致(P>0.05)。观察3组治疗成功率、治疗成功患者的恢复情况和副反应发生率、输卵管复通率等。结果对照A组成功率为81.3%(26/32),对照B组成功率为82.8%(24/29),观察组成功率为85.7%(30/35),3组治疗成功率比较差异不具有统计学意义(P>0.05);观察组治疗后血β-HCG浓度恢复正常时间及住院时间较两对照组明显缩短,差异具有统计学意义(P<0.05);3组副反应发生率及输卵管复通率比较差异无统计学意义(P>0.05)。结论输卵管插管联合肌肉注射甲氨喋呤治疗异位妊娠可明显缩短疗程,可较早判断预后,效果确切,是药物治疗的理想方式。

Objective To investigate the clinical effect of intubation of oviduct and muscle injection of methotrexate in the treatment of ectopic pregnancy.Methods 96 ectopic pregnancy patients in our hospital in July 2011 to July 2013 were randomly divided into control group A,control group B and observation group.32 patients in control group A were treated with oral mifepristone,29 patients in control group B were treated with methotrexate intramuscular injection,and 35 patients in observation group were treated with oviduct intubation combined with intramuscular methotrexate-There was no statistically significant in the distribution of age,menopause time,mass diameter,the blood HCG value before treatment in the 3 groups （P ＞ 0.05）.The treatment success,the patient＇s recovery,incidence of side effects and recanalization rate of prognosis were observed.Results The treatment success was 81.3％ （26/32） in control group A,82.8％ （24/29）in control group B and 85.7％ （30/35） in observation group.Treatment success was no statistically significant difference between 3 groups （P ＞0.05） ; The time ofβ-HCG levels back to normal after treatment and time in hospital in observation group obviously shortened than those in control group,so the difference was statistically significant （P ＜ 0.05） ; The difference was not statistical significant in incidence rate of side effects and recanalization rate after treatment （P ＞0.05）.Conclusion Intubation of oviduct and muscle injection of methotrexate in the treatment of ectopic pregnancy can obviously shorten period of treatment,judge prognosis earlier,and obtain good effect,so the therapy is the ideal way of drug treatment.