腹腔镜手术联合甲氨蝶呤治疗输卵管妊娠的临床效果观察

Observation on clinical effect of laparoscopic surgery combined with methotrexate in the treatment of tubal pregnancy

目的探讨腹腔镜手术联合甲氨蝶呤治疗输卵管妊娠的临床效果。方法60例输卵管妊娠患者作为研究对象,根据治疗方法不同分为对照组和观察组,每组30例。对照组患者采用甲氨蝶呤治疗,观察组患者采用腹腔镜手术联合局部注射甲氨蝶呤治疗。比较两组患者治疗前后人绒毛膜促性腺激素(β-HCG)水平及住院时间、不良反应发生情况。结果观察组患者的不良反应发生率为10.00%,显著低于对照组的46.67%,差异具有统计学意义(P<0.05)。两组患者治疗前β-HCG水平比较差异无统计学意义(P>0.05);观察组患者治疗后4 d、治疗后1周的β-HCG水平分别为(1367.74±220.73)、(62.20±11.87)U/L,均显著低于对照组的(1681.79±250.47)、(391.3±16.54)U/L,差异具有统计学意义(P<0.05)。观察组患者住院时间(4.02±1.36)d明显短于对照组的(9.56±3.06)d,差异具有统计学意义(P<0.05)。结论针对输卵管妊娠的治疗,相较于采用单一的甲氨蝶呤治疗,腹腔镜手术联合甲氨蝶呤治疗效果更加显著,在保证输卵管畅通、保留生育功能的同时,能明显缩短血β-HCG下降时间、住院时间,不良反应少,提高了治疗安全性,减轻了患者的经济负担。

Objective To discuss the clinical effect of laparoscopic surgery combined with methotrexate in the treatment of tubal pregnancy.Methods A total of 60 patients with tubal pregnancy as study subjects were divided into control group and observation group according to different treatment methods,with 30 cases in each group.The control group was treated with methotrexate,and the observation group was treated with laparoscopic surgery and methotrexate.The β-human chorionic gonadotropin(β-HCG)levels before and after treatment,hospitalization time,and occurrence of adverse reactions were compared between the two groups.Results The incidence of adverse reactions of the observation group was 10.00%,which was significantly lower than 46.67% of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in β-HCG between the two groups(P>0.05).1 week and 4 d after treatment,the β-HCG of the observation group were(1367.74±220.73)and(62.20±11.87)U/L,which were significantly lower than(1681.79±250.47)and(391.3±16.54)U/L of the control group,and the difference was statistically significant(P<0.05).The hospitalization time(4.02±1.36)d of the observation group was obviously shorter than(9.56±3.06)d of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with single methotrexate,combination of laparoscopic surgery and methotrexate is more effective in the treatment of ectopic pregnancy.It can significantly shorten the bloodβ-HCG decline time,hospitalization time with less adverse reactions while ensuring the unblocked fallopian tube and preserving fertility,improve the treatment safety,and reduce the economic burden of patients.