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目的探讨腹腔镜保守手术与药物联合防治输卵管妊娠后持续性异位妊娠的临床效果。方法选取我院收治的输卵管妊娠患者128例,将其随机分为治疗组与对照组。治疗组64例患者行腹腔镜保守手术将异位妊娠病灶清除后即在局部注射甲氨蝶呤(MTX)20mg,手术8h开始口服米非司酮,50mg/次,2次/d,共3d;对照组64例患者单独行腹腔镜保守手术。观察两组患者的手术时间、术中出血量、术后卧床时间、术后住院时间以及出现持续性异位妊娠的情况。结果治疗组中未发生持续性异位妊娠,对照组发生3例(4.69%),两组患者相比差异有统计学意义(P<0.05)。结论腹腔镜保守手术中清除病灶后局部注射甲氨蝶呤,并于术后服用米非司酮,能够有效预防持续性异位妊娠的发生。
Objective To investigate the clinical effect of laparoscopic conservative surgery combined with drugs in the prevention and treatment of persistent ectopic pregnancy after tubal pregnancy. Methods 128 cases of tubal pregnancy admitted to our hospital were randomly divided into treatment group and control group. Sixty-four patients in the treatment group underwent laparoscopic conservative surgery to remove 20 mg of methotrexate (MTX) locally after ectopic pregnancy. Oral mifepristone, 50 mg twice daily for 8 hours was administered orally for 8 days ; Control group of 64 patients underwent laparoscopic surgery alone. The operation time, intraoperative blood loss, postoperative bed rest, postoperative hospital stay and persistent ectopic pregnancy were observed. Results There was no persistent ectopic pregnancy in the treatment group. There were 3 cases (4.69%) in the control group. The difference between the two groups was statistically significant (P <0.05). Conclusion In laparoscopic conservative surgery, methotrexate was locally injected after focal lesion was cleared and mifepristone was taken after operation, which could effectively prevent the occurrence of persistent ectopic pregnancy.