CAJ | 학술논문

目的：探讨宫腔镜下输卵管插管注射甲氨蝶呤联合化瘀杀胚汤治疗输卵管妊娠的疗效。方法收集未破裂型输卵管妊娠患者82例，按随机化原则将研究对象分为A组和B组，其中A组为观察组41例，采用宫腔镜下输卵管插管注射甲氨蝶呤50 mg联合化瘀杀胚汤；B组为对照组41例，采用传统甲氨蝶呤50 mg肌内注射，同时口服米非司酮。按上述方案治疗2周后，观察两组临床疗效、血清促绒毛膜激素水平、输卵管包块大小及治疗后输卵管通畅情况方面的差异。结果 A组血β-HCG下降水平（1360．54 U／L）与B组下降水平（1266．29 U／L）相比，差异有统计学意义（t＝2．67，P＜0．05）；A组盆腔内输卵管包块治疗前后大小改变情况（2．3 cm）与B组（1．9 cm）比较，差异有统计学意义（t＝3．57，P＜0．05）；患侧输卵管通畅性检测A组（90．24％）优于B组（73．17％），差异有统计学意义（χ2＝100．23，P＜0．05）。结论宫腔镜下经输卵管腔注射甲氨蝶呤配合中药化瘀杀胚汤的方法治疗输卵管妊娠可有效降低血清促绒毛膜激素水平，促进输卵管妊娠包块的软化和吸收，且能够最大限度的恢复患者的生殖功能和身体健康。
목적：탐토궁강경하수란관삽관주사갑안접령연합화어살배탕치료수란관임신적료효。방법수집미파렬형수란관임신환자82례，안수궤화원칙장연구대상분위A조화B조，기중A조위관찰조41례，채용궁강경하수란관삽관주사갑안접령50 mg연합화어살배탕；B조위대조조41례，채용전통갑안접령50 mg기내주사，동시구복미비사동。안상술방안치료2주후，관찰량조림상료효、혈청촉융모막격소수평、수란관포괴대소급치료후수란관통창정황방면적차이。결과 A조혈β-HCG하강수평（1360．54 U／L）여B조하강수평（1266．29 U／L）상비，차이유통계학의의（t＝2．67，P＜0．05）；A조분강내수란관포괴치료전후대소개변정황（2．3 cm）여B조（1．9 cm）비교，차이유통계학의의（t＝3．57，P＜0．05）；환측수란관통창성검측A조（90．24％）우우B조（73．17％），차이유통계학의의（χ2＝100．23，P＜0．05）。결론궁강경하경수란관강주사갑안접령배합중약화어살배탕적방법치료수란관임신가유효강저혈청촉융모막격소수평，촉진수란관임신포괴적연화화흡수，차능구최대한도적회복환자적생식공능화신체건강。
Objective To explore the clinical effects of injecting methotrexate with hysteroscopic tubal can-nulation combined with Huayu shapei prescription in the treatment of salpingocyesis.Methods 82 unruptured salpin-gocyesis patients were randomly divided into the two groups.41 patients in the observation group were treated by hyst-eroscopic tubal cannulation injection of methotrexate combined with Huayu shapei prescription,41 patients in the con-trol group were treated by methotrexate intramuscular injection with oral mifepristone.The clinical efficacy of the two groups were observed,the level of serumβHCG required for tubal pregnancy,the mass absorption and after treatment of tubal patency.Results Compared with the control group,the difference was significant of the decline of serum βHCG in the treatment group (t=2.67,P<0.05).Compared with the control group,the treatment effectiveness and the absorption of the mass in fallopian tube in the treatment group,the difference was significant (t =3.57,P<0.05 ).Tubal patency detected treated group was superior compared with the control group,the difference was signifi-cant(χ2 =100.23,P<0.05).Conclusion Compared with traditional treatments,injecting methotrexate with hyste-roscopic tubal cannulation combined with Huayu shapei prescription in the treatment of salpingocyesis can effectively reduce the HCG levels,promote the absorption and softening of the ectopic pregnancy mass,to achieve the purpose of killing embryos eliminate micro,it will help to improve patients with clinical symptoms and signs,to maximize the recovery of the patient's reproductive function and physical health.