不同保守治疗后输卵管妊娠患者的输卵管通畅度及介入治疗后自然妊娠情况调查分析  

Investigation and analysis of tubal patency and natural pregnancy after interventional therapy in patients with tubal pregnancy treated with different conservative treatments

作　　者：冯素红 Feng Suhong(Yangxin County People's Hospital,Binzhou Shandong,256600,China)

机构地区：[1]阳信县人民医院,山东滨州256600

出　　处：《中外女性健康研究》2025年第4期63-65,185,共4页Women's Health Research

摘　　要：目的:调查分析输卵管妊娠患者行不同保守治疗后输卵管通畅度及介入治疗后自然妊娠情况。方法:选择本院(2020年1月至2022年1月)收治的输卵管妊娠患者122例临床资料进行回顾性分析,依据治疗方法分为介入治疗组(n=68),经阴道子宫输卵管超声引导下介入治疗;宫颈注射组(n=54),单次宫颈注射甲氨蝶呤;对比两组输卵管通畅度、自然妊娠情况等。结果:介入治疗组输卵管通畅率比宫颈注射组高,通而不畅率、阻塞率均比宫颈注射组的低(P<0.05)。介入治疗组治疗1周后的包块直径小于宫颈注射组,β-HCG恢复正常时间及住院时间均短于宫颈注射组(P<0.05)。介入治疗组治疗3、7、14 d时血β-HCG水平低于宫颈注射组(P<0.05)。持续对患者随访1年,与宫颈注射组相比,介入治疗组患者的宫内妊娠率更高,未受孕占比更低(P<0.05);两组重复异位妊娠发生率对比无统计学意义(P>0.05)。结论:相较于宫颈注射甲氨蝶呤相比,采用经阴道子宫输卵管超声引导下介入治疗,对输卵管通畅度作用更明显,且患者治疗后1年的自然妊娠率更高。Objective:To investigate and analyze the patency of fallopian tubes after different conservative treatments for tubal pregnancy and the natural pregnancy situation after interventional treatment.Method:The clinical data of 122 patients with tubal pregnancy admitted to our hospital(January 2020~January 2022)were retrospectively analysed and divided into an interventional treatment group(n=68)with a transvaginal uterine tubal ultrasound-guided interventional treatment according to the method of treatment,and a cervical injection group(n=54)with a single cervical injection of methotrexate,comparing the degree of patency of the tubes and the status of spontaneous pregnancy in the two groups.Result:The rate of tubal patency in the intervention group was higher than that in the cervical injection group,and the rates of patency and obstruction were lower than those in the cervical injection group(P<0.05).The diameter of the mass,the time forβ-HCG to return to normal and the hospitalisation time after 1 week of treatment in the intervention group were lower than those in the cervical injection group(P<0.05).Bloodβ-HCG levels at 3,7 and 14 d of treatment were lower in the intervention group than in the cervical injection group(P<0.05).Continuous follow-up of the patients for 1 year,compared with the cervical injection group,the patients in the intervention group had a higher rate of intrauterine pregnancy and a lower percentage of unfertilised pregnancies(P<0.05);there was no statistical significance in the comparison of the incidence of repeat ectopic pregnancies between the two groups(P>0.05).Conclusion:The use of transvaginal uterine tubal ultrasound-guided intervention has a more pronounced effect on tubal patency than cervical injections of methotrexate,and patients have a higher rate of spontaneous pregnancy 1 year after treatment.

关 键 词：输卵管妊娠 甲氨蝶呤 宫颈注射 介入治疗 输卵管通畅度 

分 类 号：R713.5[医药卫生—妇产科学]