摘要
目的 比较腹腔镜与药物保守治疗输卵管妊娠的临床效果。 方法 61例符合异位妊娠保守治疗指征,依病情、患者意愿及经济能力分为腹腔镜组(n=28)和药物组(n=33),分别采用药物 (米非司酮、甲氨蝶呤 )治疗和腹腔镜保守性手术,比较 2组患者保留输卵管率、住院日、住院费用、血β-HCG下降至正常的时间。 结果 保留输卵管成功率,腹腔镜组(27 /28)与药物组 ( 26 /33 )无统计学差异 (χ2 =2 734,P=0 098 )。腹腔镜组和药物组住院时间分别为 ( 9 1±6 1 )d和(18 3±4 6)d(t=-6 780,P=0 000);住院费用(4 017 3±1 013 7)元和 (2 039 5±790 0)元 (t=8 559,P=0 000)。血清β-HCG下降至正常时间腹腔镜组明显短于药物组(χ2 =23 054, P=0 000)。 结论 腹腔镜保守性手术清除输卵管腔内妊娠物和(或)局部注射MTX,避免腹腔内出血和持续异位妊娠,同时保留患侧输卵管;药物治疗经济实用,关键在于正确掌握保守治疗指征和必要的手术时机。2种保守治疗方法各有不可替代的临床应用价值。
Objective To compare clinical outcomes between laparoscopic oviduct-sparing operation and conservative medical treatment for tubal pregnancy. Methods A total of 61 patients with tubal pregnancy suitable for conservative treatment entered the study. According to the clinical condition, patient’s wishes and financial capability, they underwent either medical treatment (RU486 and MTX) (Medical Group,n=33) or laparoscopic conservative operation (Laparoscopic Group,n=28). The oviduct-sparing rate, length of hospital stay, hospitalization costs, and time for β-HCG to decrease to normal between the two groups were compared respectively. Results The oviduct-sparing rate was higher in the Laparoscopic Group (27/28) than the Medical Group (26/33), but without statistical difference ( χ 2 =2 734, P =0 098). The length of hospital stay was 9 1±6 1 days in the Laparoscopic Group and 18 3±4 6 days in the Medical Group, respectively ( t =-6 780, P =0 000), and the hospitalization costs was 4 017 3±1 013 7 yuan in the Laparoscopic Group and 2 039 5±790 0 yuan in the Medical Group, respectively ( t =8 559, P =0 000 ). The time for β-HCG to decrease to normal was markedly shorter in the Laparoscopic Group than the Medical Group ( χ 2= 23 054,P =0 000). Conclusions Laparoscopic techniques could thoroughly clear away the pregnant lesion in the fallopian tube, and at the same time, MTX could be coadministered locally, avoiding intraabdominal bleeding and persistent ectopic pregnancy, with the fallopian tube preserved. Medical treatment is economical, while indications for conservative treatment and surgery must be followed. Both of the options have their own clinical values.
出处
《中国微创外科杂志》
CSCD
2005年第3期192-193,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
输卵管妊娠
腹腔镜
保守性手术
药物治疗
Tubal pregnancy
Laparoscope
Conservative surgery
Medical treatment
