腹腔镜输卵管妊娠保守性手术联合甲氨喋呤与米非司酮治疗的疗效分析

目的 比较单用腹腔镜保守性手术治疗及手术加用甲氨喋呤(Methotrexate,MTX)和米非司酮(Mifepristone,RU486) 治疗输卵管妊娠的疗效.方法 98例腹腔镜下输卵管妊娠保守手术的患者分为两组,A组50例行腹腔镜切开取胚术,同时术中使用MTX 20mg输卵管系膜内注射,术后使用米非司酮150mg顿...

Effect of Laparoscopic Conservative Surgery Combined with Methotrexate and Mifepristone in Treatment of Tubal Pregnancy

Objective To explore the clinical feasibility,effect and safety of conservative treatment of tubal pregnancy under celioscope combined with Methotrexate（MTX） and Mifepristone.Methods A total of 98 patients with tubal pregnancy undergoing conservative treatment under celioscope were divided into two groups.Fifty patients in group A underwent embryo fetching surgery under celioscope with the injection of 20mg Methotrexate in mesosalpinx during the surgery and oral administration of 150mg Mifepristone after surgery.Forty-eight patients in group B underwent the surgery.The duration of operation,intraoperation blood loss,incidence of persistent ectopic pregnancy（PEP）,serum human chorionic gonadotrophin β（hCGβ） level and the intrauterine pregnancy rate within 1 year after surgery were compared between two groups.Results All surgeries were accomplished successfully.There was no significant difference between two groups in operation time and intraoperation blood loss,and no severe complications occurred.One case in group B had PEP.The serum hCGβ levels of the two groups in 1 day,4 days,12 days after operation were significantly lower than those within 24 hours before operation,and decreased with the prolong of time after surgery especially in group A（P0.01）.The intrauterine pregnancy within 1 year after surgery was higher in group A than in group B（P0.05）.Conclusion Laparoscopic conservative surgery combined with Methotrexate and Mifepristone in the treatment of tubal pregnancy can minimize the surgical injury,promote the recovery,and has few side effects.The fertility of the patients can be maintained and the PEP incidence can be decreased.