不同甲氨蝶呤给药途径联合微创保守手术对输卵管妊娠的效果对比  

Efficacy comparison between different route of methotrexate administration combined with laproscopy in salpingocyesis

作　　者：吕晓琳 艾浩 朱艳 陈方旭 

机构地区：[1]锦州医科大学附属第一医院妇产科,辽宁锦州121000

出　　处：《中国生化药物杂志》2016年第5期54-56,59,共4页Chinese Journal of Biochemical Pharmaceutics

基　　金：国家自然科学基金(81173443)

摘　　要：目的比较不同甲氨蝶呤（MTX）给药途径联合微创保守手术在输卵管妊娠妇女中的应用效果。方法选取2012年6月~2015年5月期间在锦州医科大学附属第一医院妇产科收治的112例行MTX注射联合腹腔镜保守治疗的输卵管妊娠患者,根据给药途径分为术前组（n=62）和术中组（n=50）。比较2组的术前基线资料、手术相关资料、血β-绒毛膜促性腺激素（β-HCG）情况、术后患侧输卵管通畅状况及妊娠状况。结果 2组术前基线资料与术后6个月、1年的妊娠状况比较,差异无统计学意义。所有患者术后均未出现持续性异位妊娠,术前组的手术时间、术中失血量、血β-HCG降至正常的时间均显著低于术中组（P〈0.05）,术后3 d、1周的血β-HCG水平下降率均显著高于术中组（P〈0.05）。术前组术后2、4个月患侧的输卵管通畅状况均显著优于术中组（P〈0.05）。结论与术中用药相比,微创保守手术之前应用MTX可显著缩短手术时间,减少失血量,有利于保护输卵管功能,是有生育要求的输卵管妊娠妇女的理想治疗方案。Objective To compare the effect between the different route of methotrexate （MTX） administration combined with laproscopy in the treatment of patients with salpingocyesis. Methods 112 patients with salpingocyesis receiving MTX administration combined with laproscopy from June 2012 to May 2015 in department of obstetrics and gynecology of Jinzhou medical university first affiliated hospital were enrolled and divided into preoperative group （n = 62） and intraoperative group （n = 50）. Preoperative baseline data, information related to the operation, serum human ehorionie gonadotropin （13-HCG） level, the condition of postoperative tubal patency of affected side and the status of the pregnancy were compared between two groups. Results There were no significant differences in preoperative baseline data and pregnancy condition postoperative 6 months and 1 year between two groups. No persistent eetopic pregnancy occurred postoperatively. Operation time, intraoperative blood loss and the time of serum β-HCG returning to the normal level in preoperative group were significantly lower than that in intraoperative group （ P 〈 0. 05 ）, rate of descent of serum β-HCG postoperative 3 days and 1 week were significantly higher than that in intraoperative group （P 〈 0. 05 ）. Tubal patency of affected side postoperative 2 and 4 months in preoperative group were significantly better than that in intraoperative group （ P 〈 0. 05 ）. Conclusion Compared with intraoperative medication, application of MTX before minimally invasive conservative surgery could significantly shorten the operation time, decrease the blood loss, which is beneficial to protect the function of fallopian tube, so it is the ideal of salpingocyesis patients with childbearing requests.

关 键 词：甲氨蝶呤 腹腔镜手术 输卵管妊娠 

分 类 号：R714.221[医药卫生—妇产科学]