腹腔镜开窗取胚术联合甲氨蝶呤局部注射与药物保守治疗异位妊娠后再次妊娠的临床疗效比照观察

A comparative study on the clinical effect of laparoscopic window embryotomy combined with local injection of methotrexate and drug conservative treatment for the second pregnancy after ectopic pregnancy

目的:观察腹腔镜开窗取胚术联合甲氨蝶呤局部注射治疗异位妊娠后再次妊娠的临床疗效。方法:2018年5月-2019年6月收治异位妊娠后再次妊娠患者40例,随机分为两组,各20例。对照组采用药物保守治疗;观察组采用腹腔镜开窗取胚术联合甲氨蝶呤局部注射治疗。比较两组治疗效果。结果:观察组β-HCG降至正常时间、包块消失时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组宫内妊娠率、输卵管再通率均高于对照组,患侧输卵管再次异位妊娠率及流产率均低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜开窗取胚术联合甲氨蝶呤局部注射治疗异位妊娠后再次妊娠,效果显著。

Objective:To explore the clinical effect of laparoscopic window embryotomy combined with local injection of methotrexate for the second pregnancy after ectopic pregnancy.Methods:From May 2018 to June 2019,40 patients with second pregnancy after ectopic pregnancy were selected and randomly divided into two groups of 20 cases in each.The control group was treated with drug conservative treatment.The observation group was treated with aparoscopic window embryotomy combined with local injection of methotrexate.We compared the efficacy of the two groups.Results:In the observation group,the time of β-hCG decreasing to normal,the time of mass disappearing and the time of hospitalization were shorter than that in the control group,the difference was statistically significant(P<0.05).In the observation group,the rate of intrauterine pregnancy and fallopian tube recanalization was higher than that of the control group,and the rate of ectopic pregnancy and abortion on the affected side of fallopian tube were lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The clinical effect of laparoscopic window embryotomy combined with local injection of methotrexate for the second pregnancy after ectopic pregnancy is significant.