早期未破裂EP的两种保守治疗方法的疗效与效益分析

Curative Effect and Economic Benefit of Two Kinds of Conservative Treatment for Unruptured Early EP

目的对比分析早期未破裂异位妊娠(EP)两种保守治疗方法的疗效及效益。方法随机选择该院于2008年2月—2014年6月收治的非破裂性宫外孕患者120例为研究对象,随机分为甲氨蝶呤(MTX)组60例和腹腔镜组60例,分别采用甲氨蝶呤保守治疗与腹腔镜保守治疗。结果MTX保守组成功率93.33%,腹腔镜组成功率98.33%,两组对比P<0.05(X^2=9.192);血β-HCG转阴时间,MTX保守组平均为14.36 d,腹腔镜组平均为8.86 d,两组对比P<0.05(t=2.82);平均住院时间MTX保守组为11.36 d,腹腔镜组为5.21 d,两组对比P<0.05(t=2.63);平均住院费用MTX保守组≤1500元,腹腔镜手术组≥3200元,两组对比P<0.05(t=3.24)。保守组一般不使用抗生素。腹腔镜组可同时处理伴随的疾病。结论对早期未破裂异位妊娠,腹腔镜整体疗效优于MTX药物保守治疗,但MTX药物保守治疗更经济。临床上应根据具体情况以及患者本人的意愿,综合考虑给出个性化的治疗方案。

Objective To compare the curative effect and economic benefit of two kinds of conservative treatment for unruptured early EP. Methods 120 patients with unruptured early EP from 2008 February to 2014 June were selected and randomly divided into methotrexate （MTX） group （n=60） and laparoscopic group （n=60）, respectively with methotrexate conservative treatment and laparoscopic conservative treatment. Results The success rate, β-HCG clearance time, average hospitalization time, average medical cost of the MTX group was 93.33%, 14.36 d, 11.36 d, ≤1500 RMB; while that of the laparoscopic group was 98.33%, 8.86 d, 5.21 d,≥3200 RMB;and there were statistically differences between them of the two groups, P〈0.05（χ2=9.192, t=2.82, t=2.63,t=3.24）. Antibiotics were not used in the MTX group. Concomitant diseases were treated in the laparoscopic group. Conclusion For unruptured early EP, methotrexate conservative treatment and laparoscopic conservative treatment has different advantages of better efficiency or low cost, so they should be used based on the concrete conditions and patients ’ willingness.