中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
22期
3460-3463
,共4页
甲氨蝶呤%腹腔镜%保守治疗%未破裂型输卵管妊娠%疗效
甲氨蝶呤%腹腔鏡%保守治療%未破裂型輸卵管妊娠%療效
갑안접령%복강경%보수치료%미파렬형수란관임신%료효
Methotrexate%Laparoscopic%Conservative treatment%Non -ruptured tubal pregnancy%Effects
目的：比较甲氨蝶呤与腹腔镜下输卵管切开取胚术保守治疗未破裂型输卵管妊娠临床效果。方法未破裂型输卵管妊娠患者共150例，采用随机数字表法分为 A 组和 B 组，每组各75例；A 组采用甲氨蝶呤药物保守治疗，B 组则采用腹腔镜下输卵管切开取胚术保守治疗；比较两组患者住院时间，治疗后输卵管通畅程度，宫内妊娠率、重复异位妊娠率、卵巢体积及卵泡个数等。结果 A 组和 B 组患者住院时间分别为（21．56±4．98）d，（7．91±1．42）d；B 组患者住院时间显著短于 A 组，差异有统计学意义（t ＝2．27，均 P ＜0．05）；A 组患者治疗后输卵管通畅率、通而不畅率及不通率分别为10．66％（8／75）、62．67％（47／75）、26．67％（20／75）；B 组患者治疗后输卵管通畅率、通而不畅率及不通率分别为65．33％（49／75）、26．67％（20／75）、8．00％（6／75）；B 组患者治疗后输卵管通畅率和不通率均显著优于 A 组，差异有统计学意义（χ2＝12．36，8．94，P ＜0．05）；A 组患者宫内妊娠率和重复异位妊娠率分别为30．67％（23／75）、20．00％（15／75）；B 组患者宫内妊娠率和重复异位妊娠率分别为53．33％（40／75）、8．00％（6／75）；B 组患者宫内妊娠率和重复异位妊娠率均显著优于 A 组，差异有统计学意义（χ2＝9．33、8．16，P ＜0．05）；两组患者治疗后卵巢体积比较差异无统计学意义（P ＞0．05）；B 组患者治疗后1个月、3个月及6个月卵泡个数均显著多于 A 组，差异有统计学意义（t ＝2．57、2．06、2．10，P ＜0．05）。结论相较于甲氨蝶呤药物保守治疗，腹腔镜下输卵管切开取胚术保守治疗未破裂型输卵管妊娠可有效缩短住院时间，提高输卵管通畅程度，改善远期生育结局，并有助于降低对于卵巢功能的影响。
目的：比較甲氨蝶呤與腹腔鏡下輸卵管切開取胚術保守治療未破裂型輸卵管妊娠臨床效果。方法未破裂型輸卵管妊娠患者共150例，採用隨機數字錶法分為 A 組和 B 組，每組各75例；A 組採用甲氨蝶呤藥物保守治療，B 組則採用腹腔鏡下輸卵管切開取胚術保守治療；比較兩組患者住院時間，治療後輸卵管通暢程度，宮內妊娠率、重複異位妊娠率、卵巢體積及卵泡箇數等。結果 A 組和 B 組患者住院時間分彆為（21．56±4．98）d，（7．91±1．42）d；B 組患者住院時間顯著短于 A 組，差異有統計學意義（t ＝2．27，均 P ＜0．05）；A 組患者治療後輸卵管通暢率、通而不暢率及不通率分彆為10．66％（8／75）、62．67％（47／75）、26．67％（20／75）；B 組患者治療後輸卵管通暢率、通而不暢率及不通率分彆為65．33％（49／75）、26．67％（20／75）、8．00％（6／75）；B 組患者治療後輸卵管通暢率和不通率均顯著優于 A 組，差異有統計學意義（χ2＝12．36，8．94，P ＜0．05）；A 組患者宮內妊娠率和重複異位妊娠率分彆為30．67％（23／75）、20．00％（15／75）；B 組患者宮內妊娠率和重複異位妊娠率分彆為53．33％（40／75）、8．00％（6／75）；B 組患者宮內妊娠率和重複異位妊娠率均顯著優于 A 組，差異有統計學意義（χ2＝9．33、8．16，P ＜0．05）；兩組患者治療後卵巢體積比較差異無統計學意義（P ＞0．05）；B 組患者治療後1箇月、3箇月及6箇月卵泡箇數均顯著多于 A 組，差異有統計學意義（t ＝2．57、2．06、2．10，P ＜0．05）。結論相較于甲氨蝶呤藥物保守治療，腹腔鏡下輸卵管切開取胚術保守治療未破裂型輸卵管妊娠可有效縮短住院時間，提高輸卵管通暢程度，改善遠期生育結跼，併有助于降低對于卵巢功能的影響。
목적：비교갑안접령여복강경하수란관절개취배술보수치료미파렬형수란관임신림상효과。방법미파렬형수란관임신환자공150례，채용수궤수자표법분위 A 조화 B 조，매조각75례；A 조채용갑안접령약물보수치료，B 조칙채용복강경하수란관절개취배술보수치료；비교량조환자주원시간，치료후수란관통창정도，궁내임신솔、중복이위임신솔、란소체적급란포개수등。결과 A 조화 B 조환자주원시간분별위（21．56±4．98）d，（7．91±1．42）d；B 조환자주원시간현저단우 A 조，차이유통계학의의（t ＝2．27，균 P ＜0．05）；A 조환자치료후수란관통창솔、통이불창솔급불통솔분별위10．66％（8／75）、62．67％（47／75）、26．67％（20／75）；B 조환자치료후수란관통창솔、통이불창솔급불통솔분별위65．33％（49／75）、26．67％（20／75）、8．00％（6／75）；B 조환자치료후수란관통창솔화불통솔균현저우우 A 조，차이유통계학의의（χ2＝12．36，8．94，P ＜0．05）；A 조환자궁내임신솔화중복이위임신솔분별위30．67％（23／75）、20．00％（15／75）；B 조환자궁내임신솔화중복이위임신솔분별위53．33％（40／75）、8．00％（6／75）；B 조환자궁내임신솔화중복이위임신솔균현저우우 A 조，차이유통계학의의（χ2＝9．33、8．16，P ＜0．05）；량조환자치료후란소체적비교차이무통계학의의（P ＞0．05）；B 조환자치료후1개월、3개월급6개월란포개수균현저다우 A 조，차이유통계학의의（t ＝2．57、2．06、2．10，P ＜0．05）。결론상교우갑안접령약물보수치료，복강경하수란관절개취배술보수치료미파렬형수란관임신가유효축단주원시간，제고수란관통창정도，개선원기생육결국，병유조우강저대우란소공능적영향。
Objective To investigate clinical effects of methotrexate and laparoscopic salpingotomy in the treatment of non -ruptured tubal pregnancy.Methods 150 children with non -ruptured tubal pregnancy were cho-sen and randomly divided into A group (75 children)with methotrexate treatment and B group (75 children)with laparoscopic salpingotomy.The hospital staying time,the degree of tubal patency,intrauterine pregnancy rate,ectopic pregnancy rate,ovarian volume and number of follicles after treatment of the two groups were compared.Results The hospital staying time of A group and B group were (21.56 ±4.98)d,(7.91 ±1.42)d,the hospital staying time of B group was significantly shorter than A group (t =2.27,P <0.05).The tubal patency rate,pass and not free rate and barrier rate after treatment of A group were 10.66%(8 /75),62.67%(47 /75),26.67%(20 /75),those of B group were 65.33%(49 /75),26.67%(20 /75),8.00%(6 /75),the tubal patency rate and barrier rate after treatment of B group were significantly better than A group (χ2 =12.36,8.94,P <0.05).The intrauterine pregnancy rate and ectopic pregnancy rate of A group were 30.67% (23 /75 ),20.00% (15 /75 ),those of B group were 53.33%(40 /75),8.00%(6 /75),which were significantly better than A group (χ2 =9.33,8.16,all P <0.05).There was no significant difference in ovarian volume after treatment between the two groups (P >0.05).The number of follicles in 1 month,3 months and 6 months after treatment of B group was significantly better than A group (t =2.57,2.06, 2.10,all P <0.05).Conclusion Compared with methotrexate treatment,laparoscopic salpingotomy in the treatment of non -ruptured tubal pregnancy can efficiently shorten hospital staying time,higher the degree of tubal patency, improve the long -term outcome,and is helpful to reduce the effect of ovarian function.
