高渗葡萄糖注入输卵管内预防腹腔镜手术后持续性异位妊娠83例临床分析

目的:探讨预防异位妊娠腹腔镜保守性手术后持续性异位妊娠(PEP)的方法.方法:对236例输卵管妊娠患者行腹腔镜保守手术后按入院先后分成3组:高渗葡萄糖组(83例)采用50%葡萄糖液注入患侧输卵管残腔,甲氨蝶呤组(81例)采用甲氨堞呤注射,方法同高渗葡萄糖组,对照组(72例)不用任何药物.所有患者均于术前及术后第1天、第3天、第7天检测血β-HCG值.结果:高渗葡萄糖组PEP发生1例,甲氨蝶呤组1例,对照组4例,高渗葡萄糖组与甲氨蝶呤组比较,差异无统计学意义(P>0.05),高渗葡萄糖组与对照组比较,差异有统计学意义(P<0.05);术后第1天血β-HCG值较术前明显下降,但3组间差异无统计学意义(P>0.05);术后3天、7天血β-HCG值高渗葡萄糖组与甲氨蝶呤组比较,差异无统计学意义,高渗葡萄糖组与对照组比较,差异有统计学意义(P<0.05).结论:与甲氨蝶呤相比,高渗葡萄糖也可预防腹腔镜保守性手术后PEP的发生,但没有甲氨蝶呤的药物不良反应,使用安全有效.

Clinical Analysis of 83 Cases of Hyperosmolar Glucose in Prevention of Persistent Ectopic Pregnancy after Laparoscopic Salpingostomy

Objective: Medical therapy to prevent persistent ectopic pregnancy (PEP) after conservative laparoscopic operation was investigated. Methods:236 patients with ectopic pregnancy were divided into three groups according to the time of hospitalization. 83 cases were in group A, hyperosmolar glucose was injected into the fallopian tube lumen after laparoscopic salpingostomy. 81 cases were in group B, MTX was injected in the same way, 72 cases were in group C as control group. Serum β-HCG was tested for four times, before the operation, the first, third and a week after the operation respectively. Results:There were 6 patients of PEP in this study. One patient in group A, one patient in group B, the rest four patients in group C. The incidence of PEP was not statistically significant between group A and B( P>0. 05), while the difference was significant between group A and C ( P<0. 05). Serum β-HCG in three groups descended significantly in the first 24 hours after operation, but there were no differences among these groups. As for the descending of β-HCG in day 3 and 7, there was no difference between group A and B, but the difference was magnificent between group A and C( P < 0.05). Conclusions: Compared with the MTX, hyperosmolar glucose is an effective and safer method to prevent PEP.