MTX预防腹腔镜手术后持续性异位妊娠效果分析

目的:探讨异位妊娠经腹腔镜保守性手术后预防持续性异位妊娠(PEP)的方法。方法:将130例行腹腔镜保守治疗的输卵管妊娠未破裂患者随机分成两组。A组72例采用甲氨喋呤(MTX)30 mg注入患侧输卵管残腔;B组58例除用MTX外,于术后口服米非司酮。所有患者均于术前及术后1、3、14天检测血β-HCG值,并观察副反应的发生情况。结果:130例患者中有3例发生PEP,发生率为2.31%,其中A组1例(1.39%),B组2例(3.45%),差异无显著性(P>0.05)。术后第1天两组血β-HCG值均较术前大幅度下降(P<0.01),但两组间差异无显著性(P>0.05);术后第1天、第3天血β-HCG值两组间差异无显著性(P>0.05);但第14天两组间差异有显著性,B组明显高于A组(P<0.01),且B组出现的毒副反应明显多于A组。结论:异位妊娠者经腹腔镜保守性手术后,单用MTX预防PEP要优于MTX加米非司酮。

Analysis of MTX in prevention of persistent ectopic pregnancy after laparoscopic conservative surgery

Objective:To evaluate the efficacy of MTX prophylaxis for persistent ectopic pregnancy(PEP) after laparoscopic conservative surgery for tubal pregnancy.Methods:130 ectopic pregnancy patients were randomly divided into A group(72 patients) with local injection of MTX 30 mg alone and B group (58 patients) with MTX local injection and consequently oral mifepristone.Serum β-HCG values were examined before and after treatment,and the occurrence of PEP or side reactions were observed in all of patients.Results:There were 3 cases of PEP in 130 cases(2.31%).The occurrence rate of PEP in A group and B group was 1.39% and 3.45%,separately(P>0.05);Serum β-HCG values in both groups descended significantly in the first day after operation,and the difference had no statistical significance between two groups at 1 day(P>0.05),the difference of serum β-HCG values in 1 day,3 days of post-operation were not significant between two groups(P>0.05).However,on the 14 day of post-operation,serum β-HCG in A group was significant lower than that in B group(P<0.01);and the side reaction in group B were great than that in group A.Conclusion:Patients treated with MTX alone after laparoscopic conservative surgery may present fewer side reaction and rapid serum β-HCG values reduction.