中国药业
中國藥業
중국약업
CHINA PHARMACEUTICALS
2014年
21期
85-86
,共2页
腹腔镜%天花粉蛋白%甲氨蝶呤%持续性异位妊娠
腹腔鏡%天花粉蛋白%甲氨蝶呤%持續性異位妊娠
복강경%천화분단백%갑안접령%지속성이위임신
laparoscopy%trichosanthin%methotrexate%persistent ectopic pregnancy
目的：探讨单次肌肉注射天花粉蛋白预防腹腔镜保守性手术后持续性异位妊娠的临床疗效。方法选取2010年5月至2014年5月行腹腔镜保守性治疗的异位妊娠患者144例，随机分为观察组和对照组，各72例。两组患者均行腹腔镜保守性治疗，对照组术中于病灶局部注射甲氨蝶呤20 mg，观察组于术后单次肌肉注射天花粉蛋白1.2 mg。结果观察组患者术后持续性异位妊娠发生率为5.56%，略高于对照组的2.78%，但无显著性差异（ P>0.05）。治疗后，两组患者血β－人绒毛膜促性腺激素（β－HCG）和孕酮水平均较治疗前显著下降，观察组的下降幅度大于对照组，两项指标恢复正常的时间也少于对照组（ P<0.05）。观察组盆腔包块消失时间平均为（32.51±8.43）d，明显短于对照组的（41.07±11.72）d（ P<0.05）。观察组不良反应总发生率为58.33%，明显高于对照组的31.94%（ P<0.05），但严重程度远低于对照组。结论腹腔镜保守性异位妊娠患者术后单次肌肉注射天花粉蛋白，可降低术后持续性异位妊娠发生率，快速降低血β－HCG和孕酮水平，不良反应发生率虽高但均较轻微。
目的：探討單次肌肉註射天花粉蛋白預防腹腔鏡保守性手術後持續性異位妊娠的臨床療效。方法選取2010年5月至2014年5月行腹腔鏡保守性治療的異位妊娠患者144例，隨機分為觀察組和對照組，各72例。兩組患者均行腹腔鏡保守性治療，對照組術中于病竈跼部註射甲氨蝶呤20 mg，觀察組于術後單次肌肉註射天花粉蛋白1.2 mg。結果觀察組患者術後持續性異位妊娠髮生率為5.56%，略高于對照組的2.78%，但無顯著性差異（ P>0.05）。治療後，兩組患者血β－人絨毛膜促性腺激素（β－HCG）和孕酮水平均較治療前顯著下降，觀察組的下降幅度大于對照組，兩項指標恢複正常的時間也少于對照組（ P<0.05）。觀察組盆腔包塊消失時間平均為（32.51±8.43）d，明顯短于對照組的（41.07±11.72）d（ P<0.05）。觀察組不良反應總髮生率為58.33%，明顯高于對照組的31.94%（ P<0.05），但嚴重程度遠低于對照組。結論腹腔鏡保守性異位妊娠患者術後單次肌肉註射天花粉蛋白，可降低術後持續性異位妊娠髮生率，快速降低血β－HCG和孕酮水平，不良反應髮生率雖高但均較輕微。
목적：탐토단차기육주사천화분단백예방복강경보수성수술후지속성이위임신적림상료효。방법선취2010년5월지2014년5월행복강경보수성치료적이위임신환자144례，수궤분위관찰조화대조조，각72례。량조환자균행복강경보수성치료，대조조술중우병조국부주사갑안접령20 mg，관찰조우술후단차기육주사천화분단백1.2 mg。결과관찰조환자술후지속성이위임신발생솔위5.56%，략고우대조조적2.78%，단무현저성차이（ P>0.05）。치료후，량조환자혈β－인융모막촉성선격소（β－HCG）화잉동수평균교치료전현저하강，관찰조적하강폭도대우대조조，량항지표회복정상적시간야소우대조조（ P<0.05）。관찰조분강포괴소실시간평균위（32.51±8.43）d，명현단우대조조적（41.07±11.72）d（ P<0.05）。관찰조불량반응총발생솔위58.33%，명현고우대조조적31.94%（ P<0.05），단엄중정도원저우대조조。결론복강경보수성이위임신환자술후단차기육주사천화분단백，가강저술후지속성이위임신발생솔，쾌속강저혈β－HCG화잉동수평，불량반응발생솔수고단균교경미。
Objective To study the clinical efficacy of single intramuscular injection of trichosanthin in preventing persistent ectopic pregnancy after laparoscopic conservative surgery. Methods 144 cases of laparoscopic conservative ectopic pregnancy treated by the la-paroscopic conservative therapy in our hospital from May 2010 to May 2014 were selected and randomly divided into the observation group and the control group, each of then were 72 cases. The two groups were performed the laparoscopic conservative therapy. The control group was intraoperatively given methotrexate 20 mg by local injection, while the observation group was intramuscularly injected by single trichosanthin 1. 2 mg. Results The occurrence rate of postoperative persistent ectopic pregnancy in the observation group was 5. 56%, which was slightly higher than 2. 78% in the control group, but whithout statistical differences between them ( P>0. 05 ) . The levels ofβ-HCG and progesterone after treatment were significantly decreased than before treatment, but the decrease amplitude in the observa-tion group was greater than that of the control group and the time of the two indexes recovering to normal was shorter than that in the control group ( P<0. 05 ) . The disappearance time of pelvic mass in the observation group was ( 32. 51 ± 8. 43 ) d, which was significantly shorter than ( 41. 07 ± 11. 72 ) d in the control group with statistical difference ( P<0. 05 ) . The total occurrence rate of adverse reactions in the observation group was 58. 33% , which was higher than 31. 94% in the control group ( P<0. 05 ) , but the severity in the obser-vation group was far below that in the control group. Conclusion Single intramuscular injection of trichosanthin after laparoscopic con-servative surgery for treating ectopic pregnancy may reduce the occurrence rate of postoperative persistent ectopic pregnancy, rapidly de-crease the levels of β-HCG and progesterone, the occurrence rate of adverse reactions is higher, but slight.
