腹腔镜下注射甲氨蝶呤对异位妊娠病灶清除的治疗分析

目的:探讨腹腔镜下注射甲氨蝶呤对异位妊娠病灶清除的临床疗效。方法:选取2007年1月～2009年5月于该院进行治疗的84例异位妊娠患者为研究对象,将其随机分为对照组(腹腔镜下异位妊娠术组)42例和观察组(腹腔镜下病灶清除联合甲氨蝶呤局部注射组)42例,后将两组患者的手术时间、出血量、肛门排气时间、住院时间、并发症发生率、再孕率及治疗前、治疗后3天及7天的血清β-HCG、P、VEGF(血管内皮生长因子)及PAPP-A(妊娠相关蛋白)水平进行统计及比较。结果:两组患者手术时间、出血量、肛门排气时间比较,P值均>0.05,均无统计学差异,而观察组的住院时间短于对照组,并发症发生率低于对照组,再孕率高于对照组,治疗后3天及7天的血清β-HCG、P、VEGF及PAPP-A水平均低于对照组,P值均<0.05,均有统计学差异。结论:腹腔镜下注射甲氨蝶呤对异位妊娠病灶清除的临床疗效较佳,安全性也较高,在降低血清β-HCG、P、VEGF及PAPP-A水平方面优势明显。

Analysis on the curative effect of injection of methotrexate on debridement of ectopic pregnancy under laparoscope

Objective:To explore the clinical efficacy of injection of methotrexate on debridement of ectopic pregnancy under laparoscope. Methods:Eighty-four patients with ectopic pregnancy who were treated in the hospital from January 2007 to May 2009 were selected as study objects,then they were divided into control group(laparoscopic ectopic pregnancy surgery group) and observation group(laparoscopic debridement combined with local injection of methotrexate group),42 cases in each group;the operation times,the amounts of blood loss during operation,the anal exhausting times,the hospitalization times,the incidences of complications,the rates of secondary pregnancy,the serum levels of β-human chorionic gonadotropin(β-HCG),progestogen,vascular endothelial growth factor(VEGF),and pregnancy associated plasma protein-A(PAPP-A) before treatment and at three,seven days after treatment in the two groups were analyzed statistically and compared. Results:There was no significant difference in the operation time,the amount of blood loss during operation,and the anal exhausting time between the two groups(P>0.05);the hospitalization time in observation group was significantly shorter than that in control group(P<0.05),the incidences of complications in observation group were significantly lower than those in control group(P<0.05),the rate of secondary pregnancy in observation group was significantly higher than that in control group(P<0.05),the serum levels of β-HCG,progestogen,VEGF,and PAPP-A at three and seven days after treatment in observation group were significantly lower than those in control group(P<0.05). Conclusion:The clinical efficacy of injection of methotrexate on debridement of ectopic pregnancy under laparoscope is good,the safety is high,the advantages are dominant in the way of reducing serum levels of β-HCG,progestogen,VEGF,and PAPP-A.