甲氨蝶呤联合米非司酮、开腹手术及腹腔镜治疗异位妊娠的疗效

目的:比较甲氨蝶呤联合米非司酮、开腹手术以及腹腔镜手术治疗异位妊娠的临床疗效。方法:将120例异位妊娠患者分为3组,每组40例,A组予以甲氨蝶呤联合米非司酮保守治疗,B组行开腹手术,C组行腹腔镜手术,比较3组临床疗效、血清孕酮与β-HCG变化情况及恢复正常时间,比较术者手术时间及术中出血量。结果:B、C组治愈率明显高于A组(P<0.05);C组患者血清孕酮及β-HCG值较A、B组下降快,恢复所需时间短(P<0.05);且C组手术时间短于B组,术中出血量少于B组(P<0.05)。结论:腹腔镜手术治疗异位妊娠优于开腹手术,甲氨蝶呤联合米非司酮保守治疗具有可行性,但应严格掌握适应证。

Curative effect of methotrexate combined with mifepristone,laparotomy,and laparoscopic surgery for treatment of ectopic pregnancy

Objective:To compare the clinical efficacies of methotrexate combined with mifepristone,laparotomy,and laparoscopic surgery for treatment of ectopic pregnancy.Methods:One hundred and twenty patients with ectopic pregnancy were divided into three groups,40 patients in each group: the patients in group A were treated with conservative therapy of methotrexate combined with mifepristone,the patients in group B were treated with laparotomy,and the patients in group C were treated with laparoscopic surgery;the clinical efficacies,serum levels of progesterone and β-human chorionic gonadotropin(β-HCG) and the times to return to normal levels,surgical times,and the amounts of blood loss during surgery in the three groups were compared.Results:The curative rates in group B and group C were statistically significantly higher than that in group A(P<0.05);compared with group A and group B,the speeds of decrease of serum progesterone and β-HCG in group C were faster,and the times to return to normal levels were shorter(P<0.05);the surgical time in group C was statistically significantly shorter than that in group B,the amount of blood loss during surgery in group C was statistically significantly less than that in group B(P<0.05).Conclusion:Laparoscopic surgery is superior to laparotomy for treatment of ectopic pregnancy,conservative therapy with methotrexate combined with mifepristone is feasible,but the indications should be strictly controlled.