腹腔镜手术联合甲氨喋呤治疗异位妊娠疗效观察.docVIP

腹腔镜手术联合甲氨喋呤治疗异位妊娠疗效观察【摘要】 目的 探讨腹腔镜手术联合甲氨喋呤治疗异位妊娠的疗效。方法 将2010年5月至2010年10月在广州市妇婴医院确诊为异位妊娠的56例患者随机分成两组。观察组：45例，采用腹腔镜手术联合甲氨喋呤(MTX)，对照组：11例，单采用腹腔镜手术。比较两组患者治愈成功率、治疗前、后血β?HCG下降值及两种手术的住院时间。结果 两组患者治愈成功率比较差异无统计学意义(P0?05),观察组血β?HCG降至正常的时间明显快于对照组(P0?05)。 结论 采用腹腔镜手术联合甲氨喋呤治疗异位妊娠能更快、更有效地抑制滋养细胞增长，提高疗效，缩短治疗时间，减少治疗费用。? 【关键词】 甲氨喋呤；异位妊娠；腹腔镜；血β HCG值 ?? Clinical observation of efficacy of laparoscopic surgery combining with Methotraxate in ectopic pregnancy YANG Hong?mei， ZHU Yan?hong， HUANG Xiao?fan，et al.Guangzhou Women and Children?s Medical Center, Guangzhou, 510180,China ? 【Abstract】 Objective To investigate the efficacy of laparoscopic surgery combining with Methotrexate (MTX) in ectopic pregnancy? Methods 56 patients who were diagnosed of ectopic pregnancy in Guangzhou Maternal and Infant Hospital from May to October in 2010 were randomly divided into two groups? The patients in observation group (n=45) received the treatment of laparoscopic surgery combining with MTX and those in control group received laparoscopic surgery only.Results Those were compared between two groups，including the cure rate，decrease of serum β?HCG before and after the surgery and the hospitalization time.There was no significant statistical difference of cure rate between two groups (P0?05)? The time of serum β?HCG decrease to normal level of observation group was faster than that of control group (P0?05)? Conclusion The treatment of laparoscopic surgery combining with MTX can restrain the growth of trophoblash faster and more effective, improve the efficacy, shorten the treatment time and reduce the expense.? 【Key words】 MTX;Ectopic pregnancy; Laparoscope; Serum β?HCG ? 异位妊娠是妇科最常见的急腹症, 其中以输卵管妊娠最常见，占95％??［1］?。近30年来异位妊娠的发病率不断升高,有报道发病率增加6倍,约占所有妊娠的2%而其中输卵管妊娠引起的死亡占孕妇死亡总数的9%~13%。近十余年来由于高敏感度放免测定血β?HCG及高分辨B超和腹腔镜的开展，异位妊娠早期诊断与治愈率显著提高??［2］?。在上述的56例患者中，年轻女性占1/3，且部分患者尚未生育。为使这部分患者能够保留病变的输卵管，保存其生殖生理功能，我们开展了腹腔镜手术联合局部注射甲氨蝶呤(MTX)治疗异位妊娠，临床效果满意，现报告如下。? 1 资料与方法? 1.1 一般资料 收集2010年5月至201