腹腔镜手术与药物保守治疗异位妊娠的临床效果比较

Comparison of the effects of laparoscopic surgery and medicine conservative therapy for ectopic pregnancy

目的 探讨腹腔镜手术与药物保守治疗异位妊娠的临床疗效.方法 将120例异位妊娠患者采用随机数字表法分为观察组和对照组,每组60例.对照组给予药物保守治疗,观察组给予腹腔镜手术治疗.比较两组疗效.结果 观察组人绒毛膜促性腺激素恢复正常时间、腹部包块消失时间、腹部疼痛消失时间、阴道流血消失时间、月经恢复时间和住院时间分别为（13.31±1.88）d、（5.15±1.03）d、（3.24±1.01）d、（6.57±1.26）d、（24.65±5.76）d、（4.21±1.13）d,均短于对照组,差异均有统计学意义（t=16.910、25.645、8.046、11.452、15.656、25.938,均P〈0.05）.观察组随访1年宫内妊娠率为51.67%,术后2年宫内妊娠率为58.33%,对照组随访1年宫内妊娠率为48.33%,术后2年宫内妊娠率为51.67%,两组差异均无统计学意义（x2=0.133、0.538,均P〉0.05）.观察组随访1年再次异位妊娠率为5.00%,2年再次异位妊娠率为8.33%,均低于对照组,差异均有统计学意义（x2=4.227、6.984,P〈0.05）.结论 腹腔镜手术治疗异位妊娠能够缩短临床体征消失时间,降低再次异位妊娠发生率,临床疗效可靠,值得在临床上推广应用.

Objective To compare the effect of laparoscopic surgery and medicine conservative therapy for ectopic pregnancy.Methods 120 patients with ectopic pregnancy were divided into observation group and control group by random number method,60 cases in each group.The control group was given medicine conservative treatment,the observation group was given laparoscopic surgery.The treatment effects were compared between the two groups.Results The normal time of human chorionic gonadotropin,the disappearance time of abdominal mass,the time of disappearance of abdominal pain,the time of vaginal bleeding,the time of menstruation recovery and the length of hospital stay of the observation group were （13.31±1.88）d,（5.15±1.03）d,（3.24±1.01）d,（6.57±1.26）d,（24.65±5.76）d,（4.21±1.13）d,which were shorter than those of the control group,the differences were statistically significant（t=16.910,25.645,8.046,11.452,15.656,25.938,all P〈0.05）.The 1 year intrauterine pregnancy rate of the observation group was 51.67%,the intrauterine pregnancy rate after 2 years of the observation group was 58.33%,and the 1 year intrauterine pregnancy rate of the control group was 48.33%,the intrauterine pregnancy rate after 2 years of the control group was 51.67%,the differences were not statistically significant between the two groups（x2=0.133,0.538,all P〉0.05）.Followed up for 1 year,the ectopic re-pregnancy rate of the observation group was 5.00%,the ectopic re-pregnancy rate after 2 years of the observation group was 8.33%,which were lower than those of the control group,the differences were statistically significant（x2=4.227,6.984,all P〈0.05）.Conclusion Laparoscopic surgery in the treatment of ectopic pregnancy can shorten the clinical signs disappear time and reduce the incidence of ectopic pregnancy again,its clinical curative effect is reliable,and it is worthy of popularization and application in clinic.