氨甲喋呤在输卵管妊娠腹腔镜保守手术中的应用效果(1)
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[摘要] 目的 探讨氨甲喋呤(MTX)在输卵管妊娠腹腔镜保守手术中应用对持续性异位妊娠预防的效果。 方法 将我院2006年4月～2011年6月输卵管妊娠腹腔镜保守手术治疗患者125例分成两组，其中术中应用MTX的患者72例(M组)，未应用MTX的患者53例(N组)。对持续性异位妊娠(PEP)发生率、术前及术后第1、4、7、11、14天血HCG等指标进行统计分析。 结果 两组术前及术后1、14 d血HCG差异均无统计学意义(P > 0.05)。M组PEP发生率为0(0/72)，N组PEP发生率为7.5%(4/53)。N组PEP发生率明显高于M组(P < 0.05)；术后4、7、11 d M组血HCG值均明显低于N组，差异有统计学意义(P < 0.05)。 结论 术中局部预防性使用MTX，可以明显降低术后PEP的发生率，提高术后血HCG值的转阴率。
[关键词] 氨甲喋呤；输卵管妊娠；腹腔镜术；持续性异位妊娠
[中图分类号] R714.22 [文献标识码] A [文章编号] 1673-7210(2012)04(a)-0089-02
The effect of MTX in salpingocyesis laparoscopic conservative surgery
LIU Songying
Department of Gynaecology and Obstetrics, Union Hospital of Luoyang City, He'nan Province, Luoyang 471000, China
[Abstract] Objective To discuss the effect of MTX prophylaxis persistent ectopic pregnancy in salpingocyesis laparoscopic conservative surgery. Methods 125 salpingocyesis patients underwent laparoscopic conservative surgery in our hospital from April 2006 to June 2011 were divided into two groups, of which, 72 cases taken MTX in surgery (group M); 53 cases weren't taken MTX in surgery (group N). The rate of PEP, the blood β-HCG of preoperation and the blood β-HCG of postoperation 1st, 4th, 7th, 11th, 14th were compared. Results The blood β-HCG of preoperation and the blood β-HCG of postoperation 1st, 14th were not significant different between the two groups (P > 0.05). The PEP possibility of the group M was 0 (0/72), and the group N was 7.5% (4/53), there was significant difference between the two groups (P < 0.05). The blood β-HCG of postoperation 4th, 7th, 11th were significant different between the two groups (P < 0.05). Conclusion It is effective to prevent persistent ectopic pregnancy of local injection MTX into fallopian tube lumen, and it can rise the rate of negative-inverted of the blood β-HCG.
[Key words] Methotrexate; Tubal pregnancy; Laparoseopy; Persistent ectopic pregnancy
输卵管妊娠是妇产科较为常见的一种病，随着腹腔镜手术的应用及推广，腹腔镜保守手术在治疗输卵管妊娠中得到了广泛的应用，但是术后并发症持续性异位妊娠也日益引起妇产科的重视。在治疗异位妊娠的同时，怎样更好地降低持续性异位妊娠(PEP)的发生率，笔者在本文中进行了探讨。
1 资料与方法
1.1 一般资料
2006年4月～2011年6月我院收治的输卵管妊娠患者采用腹腔镜保守手术进行治疗的共125例，分M组[72例，术中加用氨甲喋呤(MTX)]和N组(53例 ......
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