腹腔镜开窗取胚术联合甲氨蝶呤局部注射与药物保守治疗异位妊娠的临床疗效比较  

Comparison of Clinical Effects of Laparoscopic Fenestration and Local Injection of Methotrexate and Conservative Treatment of Ectopic Pregnancy

作　　者：陈爱华[1] 宋帅华 李丽[1] CHEN Ai-hua;SONG Shuai-hua;LI Li(Department of Obstetrics and Gynecology,Taixing Hospital of Traditional Chinese Medicine,Taixing,Jiangsu Province,225400 China)

机构地区：[1]泰兴市中医院妇产科,江苏泰兴225400

出　　处：《中外医疗》2020年第35期1-3,共3页China & Foreign Medical Treatment

摘　　要：目的比较异位妊娠患者应用药物保守治疗与腹腔镜开窗取胚术联合甲氨蝶呤局部注射治疗的效果。方法方便选取该院2014年1月—2018年12月收治的78例异位妊娠患者予以分组研究,分组方法为随机数表法,对照组38例,实验组40例。对照组应用药物保守治疗,实验组应用腹腔镜开窗取胚术联合甲氨蝶呤局部注射治疗,对比分析两组患者输卵管通畅情况、血β-HCG水平、症状改善时间及住院时间。结果针对输卵管通畅情况,实验组通畅率为95.00%,对照组为73.68%,差异有统计学意义(χ^2=6.80,P<0.05);实验组治疗后血β-HCG水平为(45.32±3.23)mIU/mL,对照组为(158.32±14.83)mIU/mL,差异有统计学意义(t=47.05,P<0.05)。实验组包块消失时间、腹痛消失时间、月经恢复时间、住院时间分别为(5.06±1.13)d、(4.06±0.92)d、(25.23±3.93)d、(6.02±1.21)d,较对照组显著缩短,差异有统计学意义(t=19.84、7.56、16.74、17.60,P<0.05)。结论异位妊娠患者应用腹腔镜开窗取胚术联合甲氨蝶呤局部注射治疗的效果更加确切,不仅可以提高输卵管通畅率,改善患者症状,还可以缩短患者住院时间,值得临床应用与推广。Objective To compare the effect of conservative treatment with drugs and laparoscopic fenestration combined with local injection of methotrexate in patients with ectopic pregnancy.Methods 78 patients with ectopic pregnancy admitted to the hospital from January 2014 to December 2018 were conveniently selected and divided into two groups to study.The grouping method was random number table method,with 38 cases in the control group and 40 cases in the experimental group.The control group was treated with drugs conservatively,and the experimental group was treated with laparoscopic fenestration and local injection of methotrexate.The two groups were compared and analyzed the oviduct patency,bloodβ-HCG level,symptom improvement time and hospital stay.Results Regarding the patency of the fallopian tube,the patency rate of the experimental group was 95.00%,the control group was 73.68%,the difference was statistically significant(χ^2=6.80,P<0.05).The bloodβ-HCG level after treatment in the experimental group was(45.32±3.23)mIU/mL,and the control group was(158.32±14.83)mIU/mL,the difference was statistically significant(t=47.05,P<0.05).The mass disappearance time,abdominal pain disappearance time,menstrual recovery time,and hospital stay in the experimental group were(5.06±1.13)d,(4.06±0.92)d,(25.23±3.93)d,and(6.02±1.21)d,respectively,compared with the control group significantly shortened,the difference were statistically significant(t=19.84,7.56,16.74,17.60,P<0.05).Conclusion The effect of laparoscopic fenestration and local injection of methotrexate in patients with ectopic pregnancy is more accurate.It can not only increase the patency of the fallopian tube,improve the symptoms of patients,but also shorten the length of hospital stay.It is worthy of clinical application and promotion.

关 键 词：异位妊娠 保守治疗 腹腔镜开窗取胚术 甲氨蝶呤 

分 类 号：R713[医药卫生—妇产科学]