甲氨蝶呤预防腹腔镜手术后持续性异位妊娠的研究  

Methotrexate Prophylaxis for Persistent Ectopic Pregnancy after Laparoscopic Conservative Surgery

作　　者：龙滨 徐高生 

机构地区：[1]湖南省岳阳市妇幼保健院,湖南岳阳414000

出　　处：《实用妇产科杂志》2006年第6期351-353,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨异位妊娠腹腔镜保守性手术后预防持续性异位妊娠(PEP)的方法。方法:对86例输卵管妊娠患者行腹腔镜保守性手术后随机分成两组:A组采用甲氨蝶呤(MTX)注入患侧输卵管近端残腔;B组除用MTX外,并于术后口服米非司酮。所有患者均于术前及术后24小时、72小时、7天、12天检测血-βHCG值并观察其毒副反应的发生。结果:A组PEP发生1例(2.27%),B组2例(4.76%),差异无显著性(P>0.05);术后24小时血-βHCG值较术前明显下降(P<0.01),但两组间差异无显著性(P>0.05);术后72小时、7天血-βHCG值两组间差异无显著性(P>0.05),但12天两组间差异有非常显著性,B组明显高于A组(P<0.01);且B组出现的毒副反应明显多于A组。结论:单用MTX对异位妊娠腹腔镜保守性手术后预防PEP发生,可能要优于MTX加米非司酮。Objective： To evaluate the efficacy of Methotrexate （MTX） prophylaxis for persistent ectopic pregnancy （PEP） after laparoscopic conservative surgery for tubal pregnancy. Methods：86 patients with tubal pregnancy who underwent laparoscopic conservative surgery were randomly divided into two groups：A group （44 patients） with local injection of MTX alone, B group （42 patients） with MTX local injection and consequently oral Mifepristore. Serum β- HCG values were examined before- and after-treatment, and the occurrence of PEP or side reactions were obsewed in all of patients. Results：The occurrence rate of PEP in group A and B group was 2.27% and 4.76%, separately,no significant difference （ P〉 0.05）.Serum β-HCG values dropped quickly postoperatively in all patients,the differences of serum β-HCG values in 24 hours,72 hours,and 7 days of post-operation were not significant between two groups （P〉0.05） .However, on the 12 day of post-operation, serum β-HCG in A group was signifk：ant lower than B group （ P 〈 0.01 ）. And the side reactions in group B were greater than that in group A. Conclusions： Patients who were treated with MTX alone after laparoscopic conservative surgery may present fewer side reactions and rapidly serum β-hCG value reduction.

关 键 词：甲氨堞呤 腹腔镜 持续性异位妊娠 保守性手术 

分 类 号：R714.2[医药卫生—妇产科学]