腹腔镜保守性手术后持续性异位妊娠的预防

目的:探讨腹腔镜保守性手术后预防持续性异位妊娠的方法。方法:对149例输卵管妊娠患者行腹腔镜保守性手术后随机分成3组:A组采用甲氨蝶呤20mg注入患侧输卵管近端残腔;B组同时行妊娠黄体剔除术;C组术后口服宫外孕Ⅱ号中药。术后监测3组血β-HCG下降情况和持续性异位妊娠发生率。结果:术后第1天3组血β-HCG均较术前显著下降(P<0.05)。术后第1天C组血β-HCG水平高于A组和B组(P<0.05),但A组和B组差异无统计学意义(P>0.05)。术后第3天血β-HCG水平、血β-HCG降至正常时间和持续性异位妊娠发生率,3组比较差异无统计学意义(P>0.05)。结论:妊娠黄体剔除或宫外孕Ⅱ号中药可以预防持续性异位妊娠的发生,是腹腔镜保守性手术治疗异位妊娠有效的辅助手段。

Prevention of persistent ectopic pregnancy after laparoscopic conservative operation

Objective:To explore the preventive measures of persistent ectopic pregnancy after laparoscopic conservative operation.Methods:149 patients with tubal pregnancy were divided into three groups randomly after laparoscopic conservative operation:A group with local injection of methotrexate;B group with luteectomy;C group with chinese medicine treatment.The decreasing level of β-HCG in serum and the incidence of persistent ectopic pregnancy in three groups were monitored after operation.Results:The levels of β-HCG in serum on the first day after operation in three groups were lower than those pre-operation(P<0.05).The level of β-HCG in serum on the first day after operation in C group was higher than those in A group and B group(P<0.05),but there was no difference between A group and B group(P>0.05).There was no difference in the level of β-HCG in serum on the third day after operation,the time for β-HCG declining to normal level and the incidence of persistent ectopic pregnancy between three groups(P>0.05).Conclusion:Luteectomy and chinese medicine can prevent persistent ectopic pregnancy,which are effective subsidiary treatments for ectopic pregnancy besides laparoscopic conservative operation.