腹腔镜下插管微泵缓释甲氨蝶呤治疗未破裂型输卵管妊娠可行性研究

Study on the feasibility of methotrexate through laparoscopic intubation of controlled release micropump in treatment of non- ruptured tubal pregnancy

目的通过研究腹腔镜下插管微泵缓释甲氨蝶呤治疗未破裂型输卵管妊娠的临床应用情况及其临床价值。方法60例未破裂型输卵管妊娠患者,采用腹腔镜下插管微泵缓释甲氨蝶呤治疗(实验组)和甲氨蝶呤注射保守性治疗(对照组)各30例,治愈后一段时期内进行宫腔输卵管碘油造影检查。观察两种治疗方法的血绒毛膜促性腺激素(h CG)值、包块、输卵管形态及其他生命体征,继而比较两种治疗方法的疗效、住院情况及输卵管复通率,探讨腹腔镜下插管微泵缓释甲氨蝶呤治疗未破裂型输卵管妊娠的可行性。结果实验组治疗成功率为86.67%(26/30),对照组为73.33%(22/30),差异具有统计学意义(P<0.05);实验组β-h CG转阴时间、住院时间明显短于对照组,差异有统计学意义(P<0.05);实验组术后患侧输卵管复通26例86.67%(26/30),对照组20例56.67%(17/30),差异具有统计学意义(P<0.05)。结论腹腔镜下插管微泵缓释甲氨蝶呤治疗与甲氨蝶呤注射保守性治疗都能治疗未破裂型输卵管妊娠,但是前者的治疗效果更好,住院时间也更短,更有利于恢复患者的输卵管通畅,尤其β-绒毛膜促性腺激素(h CG)>2 000 U/L,更具有一定的临床价值。

Objective To research the clinical application and value of methotrexate through laparoscopic intubation of controlled release micropump in treatment of non-ruptured tubal pregnancy. Methods Sixty patients with non-ruptured tubal pregnancy were selected and divided into experimental group （methotrexate through laparoscopic intubation of controlled release micropump） and control group （conservative treatment through injection of methotrexate） , 30 patients in each group. Uterine cavity and fallopian tube iodine oil radiography inspection was conducted after they were cured for a period of time. The levels of blood human chorionic gonadotropin （hCG） , masses, tubal morphology, and other vital signs of pregnant women in the two group were observed, the curative effects, hospitalization situations, and recanalization rates in the two groups were compared, the feasibility of methotrexate through laparoscopic intubation of controlled release micropump in treatment of non-ruptured tubal pregnancy was researched. Results There was statistically significant difference in successful rate of treatment between experimental group （86. 67%, 26/30） and control group （73.33%, 22/30） （P〈0. 05） . The negative conversion time ofβ-hCG and hospitalization time in experimental group were statistically significantly shorter than those in control group （P〈 0. 05） . The recanalization rates after operation in experimental group and control group were 86. 67% （26/30） and 56. 67% （ 17/30）, respectively, there was ＇statistically significant difference between the two groups （P〈0. 05） . Conclusion Both methotrexate through laparoscopic intubafion of controlled release micropump and conservative treatment through injection of methotrexate can treat non-ruptured tubal pregnancy, but the effect of the former is better, the hospitalization time is shorter, and the former is helpful to recovery of Fallopian tube patency, especially for the patients with β- hCG〉2 000 U/L, the former has a certain clinical value.