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目的:研究单次肌注甲氨蝶呤在腹腔镜保守性异位妊娠手术预防后持续性异位妊娠的临床疗效。方法:选取144例行腹腔镜保守性治疗的输卵管未破裂型妊娠患者,随机分为观察组和对照组,对照组常规行腹腔镜保守性治疗,观察组在对照组治疗的基础上加用甲氨蝶呤单次肌注,比较两组患者的持续性异位妊娠发生率、术后血hCG下降情况及药物不良反应发生情况。结果:对照组术后持续性异位妊娠发生率为4.17%,观察组无持续异位妊娠发生,观察组患者术后持续性异位妊娠发生率明显低于对照组(P<0.05)。观察组患者腹腔镜保守治疗术后3天、7天、12天血hCG明显低于对照组(P<0.05)。观察组患者血hCG降至正常所用时间为(9.13±3.12)天,对照组为(16.25±4.53)天,观察组患者血hCG降至正常所需时间明显短于对照组(P<0.05)。观察组1例患者出现轻微胃肠道不良反应,对照组未出现明显药物不良反应。结论:在腹腔镜保守性异位妊娠患者术中单次肌注甲氨蝶呤,可降低术后持续性异位妊娠发生率及术后血hCG水平,缩短血hCG降至正常所用时间,临床疗效显著。
Objective: To study the clinical efficacy of single intramuscular methotrexate in the treatment of persistent ectopic pregnancy after laparoscopic conservative ectopic pregnancy. Methods: One hundred and forty-four patients with tubal unruptured pregnancy undergoing laparoscopic conservative treatment were randomly divided into observation group and control group. The control group was routinely treated with laparoscopic conservative treatment. The observation group was treated with the control group with a A single intramuscular injection of methotrexate, compared the incidence of persistent ectopic pregnancy, postoperative blood hCG decline and adverse drug reactions. Results: The incidence of persistent ectopic pregnancy in the control group was 4.17%. No ectopic pregnancy occurred in the observation group. The incidence of persistent ectopic pregnancy in the observation group was significantly lower than that in the control group (P <0.05). In the observation group, the hCG of 3 days, 7 days and 12 days after laparoscopic conservative treatment was significantly lower than that of the control group (P <0.05). In the observation group, the hCG decreased to normal (9.13 ± 3.12) days in the control group and (16.25 ± 4.53) days in the control group. The time required for the blood hCG in the observation group to decrease to normal was significantly shorter than that in the control group (P <0.05). One patient in the observation group had mild gastrointestinal adverse reactions, and no obvious adverse drug reactions in the control group. Conclusion: Intraperitoneal injection of methotrexate intraoperatively in patients with conservative laparoscopic ectopic pregnancy can reduce the incidence of postoperative persistent ectopic pregnancy and postoperative serum hCG levels, shorten the time required for the reduction of blood hCG to normal, clinical Significant effect.