单次肌注甲氨蝶呤在腹腔镜术后预防持续性异位妊娠的效果  

Preventive effect of single intramuscular injection of methotrexate for persistent ectopic pregnancy after laparoscopic conservative surgery

作　　者：王静[1] 俞娟[1] 黄海星[1] 

机构地区：[1]浙江省杭州市余杭区妇幼保健院,311100

出　　处：《中国妇幼保健》2014年第18期2990-2992,共3页Maternal and Child Health Care of China

基　　金：浙江省余杭区科技局项目〔2011-医药卫生-13〕

摘　　要：目的:研究单次肌注甲氨蝶呤在腹腔镜保守性异位妊娠手术预防后持续性异位妊娠的临床疗效。方法:选取144例行腹腔镜保守性治疗的输卵管未破裂型妊娠患者,随机分为观察组和对照组,对照组常规行腹腔镜保守性治疗,观察组在对照组治疗的基础上加用甲氨蝶呤单次肌注,比较两组患者的持续性异位妊娠发生率、术后血hCG下降情况及药物不良反应发生情况。结果:对照组术后持续性异位妊娠发生率为4.17%,观察组无持续异位妊娠发生,观察组患者术后持续性异位妊娠发生率明显低于对照组(P<0.05)。观察组患者腹腔镜保守治疗术后3天、7天、12天血hCG明显低于对照组(P<0.05)。观察组患者血hCG降至正常所用时间为(9.13±3.12)天,对照组为(16.25±4.53)天,观察组患者血hCG降至正常所需时间明显短于对照组(P<0.05)。观察组1例患者出现轻微胃肠道不良反应,对照组未出现明显药物不良反应。结论:在腹腔镜保守性异位妊娠患者术中单次肌注甲氨蝶呤,可降低术后持续性异位妊娠发生率及术后血hCG水平,缩短血hCG降至正常所用时间,临床疗效显著。Objective To study the clinical effect of single intramuscular injection of methotrexate for preventing persistent ectopicpregnancy after laparoscopic conservative surgery. Methods： A total of 144 patients with unrnptured tubal pregnancy treated with laparoscopic conservative surgery were selected and randomly divided into observation group and control group ; the patients in control group weretreated with routine laparoscopic conservative surgery, while the patients in observation group were treated with single intramuscular injectionof methotrexate combined with routine laparoscopic conservative surgery; the incidence rates of persistent ectopic pregnancy, decreasing amplitudes of postoperative blood human chorionic gonadotropin （HCG） level and adverse reactions in the two groups were compared. Results：The incidence rate of persistent ectopic pregnancy after laparoscopic conservative surgery in control group was 4. 17% , no persistent ectopicpregnancy occurred in observation group, the incidence rate of persistent ectopic pregnancy after laparoscopic conservative surgery in observation group was statistically significantly lower than that in control group （ P 〈 0. 05 ） . Blood HCG levels at 3, 7 and 12 days after laparo-scopic conservative surgery in observation group were statistically significantly lower than those in control group （ P 〈 0. 05 ） . The times forblood HCG level returning to normal range in observation group and control group were （9. 13 ± 3.12） days and （16. 25 ±4. 53 ） days, re-spectively, the time for blood HCG level returning to normal range in observation group was statistically significantly shorter than that in con-trol group （ P 〈 0. 05 ） . In observation group, one patient was found with mild gastrointestinal adverse effects, no obvious adverse reactionsoccurred in control group. Conclusion： Single intramuscular injection of methotrexate combined with routine laparoscopic conservative surgery can reduce the incidence rate of postoperative persistent

关 键 词：单次肌注 甲氨蝶呤 腹腔镜 持续性宫外孕 

分 类 号：R719[医药卫生—妇产科学]