氨甲蝶呤联合米非司酮对输卵管妊娠术后持续性异位妊娠的预防作用  

Preventive Effect of Methotrexate Combined with Mifepristone on Persistent Ectopic Pregnancy after Tubal Pregnancy

作　　者：涂美玲 孙琴 TU Meiling;SUN Qin(Department of Obstetrics and Gynecology,Second People's Hospital of Jingzhou City,Jingzhou 434318,China)

机构地区：[1]荆州市公安县二人民医院妇产科,湖北荆州434318

出　　处：《中国医药指南》2021年第26期88-89,92,共3页Guide of China Medicine

摘　　要：目的讨论输卵管妊娠患者在腹腔镜术后接受氨甲蝶呤联合米非司酮治疗,对预防持续性异位妊娠的意义。方法将我院妇产科在2017年3月至2018年12月收治的82例择期行腹腔镜保守性手术治疗的输卵管妊娠患者随机进行分组,各41例,观察对照组(术中在手术部位喷洒氯化钠与甲氨蝶呤混合溶液)、研究组(在其基础上术后口服米非司酮)的临床疗效。结果术前、术后第1日、术后第4日两组血清β-HCG比较,差异无统计学意义,P>0.05。术后第12日研究组血清β-HCG水平低于对照组,P<0.05。研究组住院时间、术中出血量、手术时间优于对照组,P<0.05。研究组持续性异位妊娠率低于对照组,P<0.05。研究组输卵管通畅率与1年内宫内妊娠率高于对照组,P<0.05。结论氨甲蝶呤联合米非司酮疗法安全可靠,可有效降低术后持续性异位妊娠的发生率。Objective To investigate the value of methotrexate combined with mifepristone in the treatment of persistent ectopic pregnancy after laparoscopic surgery.Methods Eighty-two patients with tubal pregnancy who underwent elective laparoscopic conservative surgery were enrolled in the Department of Obstetrics and Gynecology our hospital from March 2017 to December 2018.All patients were randomly divided into 2 groups.The control group was observed during surgery.The topical spray of sodium chloride and methotrexate mixed solution),the study group(on the basis of oral mifepristone after oral administration)clinical efficacy.Results There was no significant difference in serum β-HCG between the two groups before operation,1 day after operation and 4 days after operation,P>0.05.The level of serum β-HCG in the study group was lower than that in the control group on the 12th day after surgery,P<0.05.The hospitalization time,intraoperative blood loss and operation time of the study group were better than the control group,P<0.05.The rate of persistent ectopic pregnancy in the study group was lower than that in the control group,P<0.05.The patency rate of fallopian tubes in the study group and the intrauterine pregnancy rate in 1 year were higher than those in the control group,P<0.05.Conclusion Methotrexate combined with mifepristone is safe and reliable,which can effectively reduce the incidence of postoperative persistent ectopic pregnancy.

关 键 词：腹腔镜手术 异位妊娠 氨甲蝶呤 米非司酮 

分 类 号：R713.8[医药卫生—妇产科学]