宫腔镜下输卵管插管注入甲氨蝶呤联合米非司酮治疗输卵管妊娠的疗效及对卵巢功能、生育结局的影响

Effect of tubal catheterization with methotrexate combined with mifepristone on tubal pregnancy under hysteroscopy and its effect on ovarian function and fertility outcome

目的探讨宫腔镜下输卵管插管注入甲氨蝶呤联合米非司酮治疗输卵管妊娠的疗效及对卵巢功能、生育结局的影响。方法200例输卵管妊娠患者随机分为试验组和对照组，每组100例。对照组单纯采用米非司酮治疗；试验组采用宫腔镜下输卵管插管注入甲氨蝶呤联合米非司酮治疗。比较两组患者的疗效、对卵巢功能和生育结局的影响以及不良反应发生情况。结果治疗后，试验组治愈率明显高于对照组（91.00%〉79.00%）（P〈0.05）；治疗后，试验组患者卵巢窦卵泡数、卵巢储备功能正常率高于对照组（P〈0.05）；试验组宫内妊娠率明显高于对照组（90.00%〉79.00%）（P〈0.05）；试验组异位妊娠率明显低于对照组（8.00%〈15.00%）（P〈0.05）；试验组总未孕率明显低于对照组（2.00%〈6.00%）；试验组总不良反应发生率明显低于对照组（7.00%〈16.00%）（P〈0.05）。结论宫腔镜下输卵管插管注入甲氨蝶呤联合米非司酮治疗输卵管妊娠临床效果明显，可改善患者卵巢功能和生育结局，不良反应发生率低，值得临床推广应用。

Objective To investigate the efficacy of hysteroscopic tubal catheterization with methotrexate combined with mifepristone on tubal pregnancy and its influence on ovarian function and fertility outcome.MethodsThe data of 200 patients with tubal pregnancy were analyzed, and the 200 patients were divided into treatment group and control group, with 100 cases in each group. The patiens in control group were treated with mifepristone, and the patients in treatment group were treated by injecting oviduct under hysteroscope and methotrexate combined with mifepristone. The curative effect, ovarian function, fertility outcome and adverse reactions were compared between the two groups.ResultsAfter treatment, the cure rate of experimental group was significantly higher than that of the control group （91% vs 79%） （P〈0.05）; after treatment, the ovarian antral follicle number, ovarian function normal rate in experimental group were higher than the control group （P〈0.05）; the pregnancy rate of intrauterine test group was significantly higher than those of the control group （90% vs. 79%） （P〈0.05）; the ectopic pregnancy rate in experimental group was significantly lower than that of the control group （8% vs. 15%） （P〈0.05）; the total non pregnant rate in experimental group was significantly lower than that in the control group （2% vs. 6%）; the adverse reaction rate in experimental group was significantly lower than that in the control group （7% vs. 16%） （P〈0.05）.ConclusionsThe effect of hysteroscopic tubal catheterization and injection of methotrexate combined with mifepristone on tubal pregnancy is obvious, and it can improve the ovarian function and fertility outcomes of patients, and the incidence of adverse reactions is low, so it is worthy of clinical application.