甲氨蝶呤在输卵管妊娠保守性手术中的应用分析

目的:探讨甲氨蝶呤(MTX)在输卵管妊娠保守性手术中的作用。方法:回顾性分析本院2007年8月-2010年8月间收治的经腹腔镜保守性手术治疗的输卵管妊娠患者160例。治疗组93例行输卵管切开取胚术或挤压取胚术后于输卵管妊娠部位的输卵管系膜处注入MTX 25mg;对照组67例手术方法相同,但不行MTX局部注射。结果:治疗组与对照组相比,血β-HCG下降快,持续性异位妊娠的发生率低,住院时间短,术后3个月输卵管的通畅率高,差异均有显著性(P<0.05)。但术后同侧异位妊娠及宫内妊娠发生率,两组对比无显著性差异(P>0.05)。结论:输卵管妊娠保守性手术中应用MTX疗效快,能有效地保留输卵管,增加术后输卵管的通畅率,住院时间短,值得临床应用。

Analysis on Application of Methotrexate in Tubal Pregnancy Conservative Operation

Objective：To investigate the application of methotrexate（MTX）in tubal pregnancy conservative operation.Methods：Retrospective analysis of 160 cases in our hospital were treated by laparoscopic conservative operation for tubal pregnancy from August 2007 to August 2010.The treatment group,93 cases,was treated with fallopian tube incision embryo-taking surgery or extrusion embryo-taking surgery and injection of MTX 25mg at the mesosalpinx of fallopian pregnancy site after operation;the control group of 67 cases operation method was the same,but not with MTX local injection.Results：The treatment group compared with the control group,serum β-HCG decreases quickly,occurrence rate of persistent ectopic pregnancy was low,short hospitalization time,3 months after the operation of tubal patency rate is high,the difference was significant（P〈0.05）.But after operation,ipsilateral ectopic pregnancy and intrauterine pregnancy incidence rate,two groups had no significant difference（P〈0.05）.Conclusion：The application of MTX in tubal pregnancy conservative operation can make the fast curative effect,retain oviduct effectively,increase the postoperative fallopian tube patency rate,with shorter hospitalization time,and worthy of clinical application.