腹腔镜联合小剂量甲氨蝶呤治疗异位妊娠价值和安全性研究.docVIP

腹腔镜联合小剂量甲氨蝶呤治疗异位妊娠价值和安全性研究 　　doi：10.3969/j.issn.1007-614x.2014.17.35 　　摘要目的：探讨腹腔镜联合小剂量MTX（甲氨蝶呤）治疗异位妊娠的价值和安全性。方法：2009年1月-2013年1月收治异位妊娠患者100例，随机将其分为试验组和对照组，每组50例。试验组采用腹腔镜联合小剂量MTX进行治疗，对照组采用MTX保守治疗。结果：试验组的治愈率、输卵管再通率显著高于对照组，P0.05；试验组的持续性异位妊娠发生率显著低于对照组，P0.05；试验组患者治疗后1天、7天、14天的血β-HCG水平均显著低于对照组，P0.05。结论：与MTX保守治疗相比，腹腔镜联合小剂量MTX治疗异位妊娠的疗效更好，且安全性高，具有重要的临床应用价值。 　　关键词异位妊娠腹腔镜甲氨蝶呤 　　Study on the value and safety of laparoscopic combined with small dose methotrexate in the treatment of ectopic gestation 　　Sun Changqin 　　Jinan Jiale Infertility Hospital，Shandong 250002 　　AbstractObjective：To explore the value and safety of laparoscopic combined with small dose MTX（methotrexate） in the treatment of ectopic gestation.Methods：100 cases with ectopic gestation were selected from January 2009 to January 2013. They were randomly divided into the experimental group and the control group with 50 cases in each.The experimental group were treated with laparoscopy combined with small dose MTX treatment.The control group were treated with the MTX conservative therapy.Results：The cure rate and fallopian tube recanalization rate of the experimental group were significantly higher than those of the control group（P0.05）.The incidence rate of persistent ectopic gestation was significantly lower than that of the control group（P0.05）.1 day，7 days，14 days after treatment，the bloodβ-HCG levels of the experimental group were significantly lower than those of the control group（P0.05）.Conclusion：Compared with the MTX conservative treatment，laparoscopy combined with small dose MTX in the treatment of ectopic gestation has better curative effect，and high safety.It has a important value in clinical application. 　　Key wordsEctopic gestation；Laparoscopy；Methotrexate 　　异位妊娠属于一种妇产科极为常见的急腹症，导致异位妊娠的因素较多，最主要的病因就是输卵管炎症，如输卵管周围炎、黏膜炎等[1]。在异位妊娠的治疗中，药物保守治疗最为常用的化学药物就是MTX，其能对绒毛造成破坏，促使胚胎组织坏死、吸收，达到治疗目的[2]。随着腹腔镜技术的不断发展，近年来腹腔镜在异位妊娠的临床中的应用也日益广泛。为探讨腹腔镜联合小剂量MTX治疗异位妊娠的疗效，本研究对100例采用不同方式治疗的异位妊娠患者的临床资料进行了回顾性分析，现报告如下。 　　资料与方法