异位妊娠患者行腹腔镜手术与甲氨蝶呤保守治疗的临床效果及对再孕影响的对比分析

Clinical Effect of Laparoscopic Surgery and Conservative Treatment with Methotrexate in Ectopic Pregnancy and Its Effect on Repregnancy

目的探讨异位妊娠患者行腹腔镜手术与甲氨蝶呤保守治疗的临床效果及对再孕影响。方法选取自2015年01月-2018年06月于某院进行治疗的82例异位妊娠患者,依据患者是否愿意手术分为手术组与保守组。保守组行甲氨蝶呤治疗方案,手术组行手术治疗方案。比较两组患者治疗情况、治疗后4个月输卵管造影检查情况以及治疗后1年再次妊娠情况。结果手术组患者住院时间、血β-h CG恢复正常水平时间短于保守组,疼痛发生率低于保守组,差异有统计学意义(P<0.05)。治疗后4个月输卵管造影检查,手术组患者输卵管通畅率为95.12%,显著高于保守组80.49%,差异具有统计学意义(P<0.05)。治疗1年后所有患者均正常进行性生活,未行避孕措施。经统计手术组宫内妊娠率显著高于保守组,差异具有统计学意义(P<0.05)。结论异位妊娠患者行腹腔镜手术治疗,相比于甲氨蝶呤治疗方案能够减少住院时间、减少腹痛的发生、加快患者β-h CG恢复正常、提高输卵管通畅率以及再次妊娠成功率,具有重要的临床意义。

Objective To explore clinical effect of laparoscopic surgery and conservative treatment with methotrexate in ectopic pregnancy and its effect on repregnancy.Methods 82 patients with ectopic pregnancy who were treated in our hospital from January 2015 to June 2018 were divided into operation group and conservative group according to their willingness to operate.The conservative group was treated with methotrexate and the operative group was treated with surgery.The treatment,salpingography at 4 months after treatment and pregnancy at 1 year after treatment were compared between the two groups.Results The hospitalization time and blood beta-h CG recovery time of the operation group were shorter than those of the conservative group,and the incidence of pain was lower than that of the conservative group(P<0.05).Four months after treatment,salpingography showed that the patency rate of fallopian tube in operation group was 95.12%,which was significantly higher than that in conservative group(80.49%,P<0.05).After 1 year of treatment,all patients had normal sexual life without contraceptive measures.The intrauterine pregnancy rate in operation group was significantly higher than that in conservative group(P<0.05).Conclusion Compared with methotrexate,laparoscopic surgery for ectopic pregnancy can reduce hospitalization time,reduce abdominal pain,accelerate the recovery of beta-hCG,improve the patency rate of fallopian tube and the success rate of second pregnancy,which has important clinical significance.