摘要
目的:探讨腹腔镜手术+甲氨蝶呤对异位妊娠患者生育功能的影响.方法:选取2013年1月-2016年1月在笔者所在医院接受治疗的82例异位妊娠患者,随机分为对照组(n=40)和观察组(n=42).对照组进行腹腔镜手术治疗,观察组在此基础上使用药物甲氨蝶呤,比较两组术中出血量、手术时间、术后β-人绒毛膜促性腺激素(β-hCG)降至正常时间、住院时间;检测术前和术后24 h两组凝血功能和孕酮水平并进行对比分析;治疗后6个月,检查并记录患者输卵管通畅率,统计3年内正常妊娠率、再次异位妊娠率.结果:观察组术中出血量少于对照组,手术时间、术后β-hCG降至正常时间、住院时间均短于对照组,差异均有统计学意义(P<0.05).治疗前两组孕酮及凝血功能比较差异无统计学意义(P>0.05),治疗后,观察组凝血酶时间短于对照组,孕酮水平低于对照组,纤维蛋白原浓度高于对照组,差异均有统计学意义(P<0.05).治疗后6个月,观察组输卵管通畅率高于对照组,差异有统计学意义(P<0.05);治疗后3年内观察组再次异位妊娠率低于对照组,差异有统计学意义(P<0.05);两组治疗后3年内正常妊娠率比较差异无统计学意义(P>0.05).结论:与单纯腹腔镜手术治疗异位妊娠患者相比,腹腔镜手术+甲氨蝶呤治疗效果更好,能够缩短治疗时间,加快患者恢复,增大患者宫内受孕的概率.
Objective:To explore the effect of laparoscopic surgery plus Methotrexate on reproductive function in patients with ectopic pregnancy.Method:Eightytwo patients with ectopic pregnancy who received treatment in the author's hospital from January 2013 to January 2016 were selected,and were randomly divided into control group(n=40)and observation group(n=42).The control group was treated with laparoscopic surgery,while the observation group was treated with Methotrexate on this basis.The amount of intraoperative bleeding,the time of operation,the time ofβ-human chorionic gonadotropin(β-hCG)to normal and the time of hospitalization were compared between the two groups.The coagulation function and progesterone level were measured before and 24 hours after operation.Six months after treatment,the tubal patency rate was examined and recorded,and the normal pregnancy rate and the rate of ectopic pregnancy again within 3 years were counted.Result:The amount of blood loss in the observation group was less than that in the control group,the operation time,the postoperativeβ-hCG decreased to normal time,and the hospitalization time was shorter than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in progesterone and coagulation function between the two groups before treatment(P>0.05).After treatment,the time of thrombin in the observation group was shorter than that in the control group,the level of progesterone was lower than that in the control group,and the concentration of fibrinogen was higher than that in the control group,the differences were statistically significant(P<0.05).Six months after treatment,the tubal patency rate in the observation group was significantly higher than that in the control group(P<0.05),the rate of ectopic pregnancy in the observation group was lower than that in the control group within 3 years after treatment(P<0.05),but there was no significant difference in the normal pregnancy rate between the two groups within 3 years after treatment(P>0.05).Conclusion:Compared with simple laparoscopic surgery for ectopic pregnancy,laparoscopic surgery plus Methotrexate is more effective;it can shorten the treatment time,accelerate the recovery of patients,and increase the probability of intrauterine pregnancy.
作者
黄红来
HUANG Honglai(Dehe Hospital of Chibi City,Chibi 437300,China)
出处
《中外医学研究》
2020年第2期142-144,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
异位妊娠
甲氨蝶呤
腹腔镜手术
生育功能
Ectopic pregnancy
Methotrexate
Laparoscopic surgery
Fertility function
