腹腔镜手术联合术中用药预防输卵管妊娠后持续性异位妊娠临床疗效和安全性

Clinical Curative Effect and Safety of Laparoscopic Operation Combined with Intraoperative Medication in Preventing Persistent Ectopic Pregnancy after Tubal Pregnancy

目的探讨和研究在预防输卵管妊娠后持续性异位妊娠治疗过程中选取腹腔镜手术联合术中用药的价值和意义。方法遵循随机数字表的方法将方便选取的2014年1月—2015年1月期间在该院妇科治疗的120例输卵管异位妊娠后持续性异位妊娠患者作为研究对象并按照双盲对照原则将其分为对照组(60例)和观察组(60例),入组所有患者在治疗过程中均选取腹腔镜手术进行治疗,而观察组患者术中同时给予米非司酮联合甲氨蝶呤(MTX)治疗,对比和分析两组患者治疗效果。结果观察组患者手术耗时(73.1±15.2)min短于对照组患者(93.5±16.2)min,出血量(63.5±20.5)m L少于对照组患者(152.8±33.5)m L,住院天数(4.2±1.3)d少于对照组患者(7.4±1.5)d,PEP发生率1.67%低于对照组患者11.67%,输卵管的通畅率83.33%显著高于对照组患者58.33%,以上比较差异具有统计学意义(P<0.05)。结论输卵管妊娠后持续性异位妊娠在应用腹腔镜治疗同时加用米非司酮和MTX,在取得显著疗效同时降低患者痛苦,值得临床推荐。

Objective To study and research the value and significance of the selection of laparoscopic operation combined with intraoperative medication in preventing persistent ectopic pregnancy after tubal pregnancy. Methods 120 cases of patients with persistent ectopic pregnancy after tubal pregnancy treated in the department of gynecology of our hospital from January 2014 to January 2015 were randomly selected as the research objects and double-blindly divided into the control group and the observation group with 60 cases in each, all patients were treated with laparoscopic operation during treatment, at the same time, the observation group were treated with mifepristone combined with methotrexate, and the treatment effects of the two groups were compared and analyzed. Results The operation time in the observation group was shorter than that in the control group, [（73.1±15.2） min vs（93.5±16.2） min], the blood loss in the observation group was less than that in the control group, [（63.5±20.5） ml vs（152.8±33.5） ml], the length of stay in the observation group was fewer than that in the control group, [（4.2±1.3） d vs（7.4±1.5） d], the incidence rate of PEP in the observation group was fewer than that of the control group,（1.67% vs 11.67%）, and the patency rate of fallopian tube in the observation group was obviously higher than that in the control group,（83.33% vs 58.33%）, and all differences had statistical significance by comparison（P〈0.05）. Conclusion The clinical curative effect of laparoscope combined with mifepristone and MTX treatment for persistent ectopic pregnancy after tubal pregnancy is obvious, and it can reduce pains of patients, which is worth clinical recommendation.