宫腔镜下输卵管插管注射甲氨蝶呤在输卵管妊娠保守治疗中的效果观察  

Observation on the effect of injection of MTX in the treatment of tubal pregnancy by hysteroscopy

作　　者：符婕[1] 陈慧娟[1] 栾莹[1] 

机构地区：[1]佳木斯市中心医院妇产科,黑龙江佳木斯154002

出　　处：《中国医学前沿杂志（电子版）》2015年第11期50-54,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探究宫腔镜下输卵管插管注射甲氨蝶呤在输卵管妊娠保守治疗中的临床疗效。方法回顾性分析本院2012年9月至2014年9月收治的164例未破裂型输卵管妊娠患者的临床资料,根据临床处置不同分为A组（62例）,B组（62例）和C组（40例）。A组患者宫腔镜下输卵管插管注射甲氨蝶呤50 mg;B组患者采用甲氨蝶呤单次肌内注射,50 mg/m2,监测血β-人绒毛膜促性腺激素（β-HCG）水平,若给药4~7天后血β-HCG水平下降低于15%,则重复给药1次;C组患者于腹腔镜下行输卵管切开取胚术。比较三组患者治疗成功率、治疗效果、住院时间及不良反应发生率等,重点比较A、B两组。结果 A组患者治疗成功率为95.4%,B组为90.3%,C组为92.5%。治疗后,A、B两组患者的妊娠包块直径均显著减小,血β-HCG及孕酮水平显著下降,且A组患者改善程度明显优于B组（P〈0.05）。A组患者住院时间明显短于B、C组（P〈0.05）。A组患者不良反应发生率明显低于B、C组（P〈0.05）。结论宫腔镜下输卵管插管注射甲氨蝶呤治疗输卵管妊娠,患者血β-HCG转阴时间短,妊娠包块缩小快,不良反应少,值得临床推广应用。Objective To explore the clinical efficacy of MTX injection in the treatment of tubal pregnancy by hysteroscopy. Method To analyzed 164 cases of non-ruptured tubal pregnancy in our hospital from September 2012 to September 2014, according to the clinical treatment, the patients were divided into group A（62 cases）, group B（62 cases） and group C（40 cases）. Patients in group A were treated with 50 mg MTX. Patients in group B were treated with MTX single intramuscular injection, 50 mg/m2 and monitored blood β-HCG, if administered after 4 ~ 7 days drop below 15%, repeat it once. Patients in group C were treated with salpingotomies. Treatment success rate, treatment effect, length of stay, adverse reaction rate among the three groups after treatment were compared, and focus on A, B group. Result Treatment success rate of group A was 95.4%, group B was 90.3%, group C was 92.5%. After treatment, the diameter of the masses of group A and group B were significantly decreased, blood β-HCG level also decreased significantly, the improvement of group A were significantly better than group B（P〈0.05）. The length of stays of group A was shorter,than group B group C（P〈0.05）. The adverse reaction rate of group A was lower than group B and group C（P〈0.05）. Conclusion Hysteroscopy tubal intubation injection of MTX in the treatment of tubal pregnancy, blood β-HCG clearance time is short, pregnancy masses reduce fast, adverse reaction are less, it is worthy of clinical popularization and application.

关 键 词：宫腔镜 异位妊娠 甲氨蝶呤 保守治疗 

分 类 号：R714.22[医药卫生—妇产科学]