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目的探讨异位妊娠预治疗后行腹腔镜保守性手术与异位妊娠根治性手术术后血β-HCG下降的情况。方法回顾分析65例在我院住院的异位妊娠患者。经患者知情同意后将其分为两组。实验组患者腹腔镜手术前给予甲氨蝶呤加米非司酮预治疗,于治疗的4~7d后行腹腔镜保守性手术。对照组患者异位妊娠确诊后不要求保留患侧输卵管,予行腹腔镜根治性手术(患侧输卵管切除术)。观察两组手术后血β-HCG下降的程度与速度及转阴时间。结果实验组与对照组术后血β-HCG平均转阴时间相近,下降程度差异无统计学意义。结论在有观察及治疗条件的情况下,输卵管妊娠在手术前给予积极的预治疗,术后血β-HCG下降与根治性手术基本相同,但其可保留患侧输卵管,提高患者以后受孕的机会。
Objective To investigate the decline of serum β-HCG after laparoscopic conservative surgery and ectopic pregnancy after radical operation in pre-treatment of ectopic pregnancy. Methods Retrospective analysis of 65 cases of ectopic pregnancy hospitalized in our hospital. Patients were divided into two groups with informed consent. Patients in the experimental group were given methotrexate and mifepristone before laparoscopic surgery, and laparoscopic conservative surgery was performed after 4 to 7 days of treatment. Patients in the control group were not required to retain the ipsilateral fallopian tubes after diagnosis of ectopic pregnancy, and underwent laparoscopic radical surgery (ipsilateral tubal resection). The extent and rate of decline of blood β-HCG after operation and the time of negative conversion were observed. Results The mean time of postoperative β-HCG in experimental group and control group was similar, but the difference was not statistically significant. Conclusions Under the condition of observation and treatment, tubal pregnancy is given pre-treatment actively before operation. The postoperative blood β-HCG decline is basically the same as that of radical surgery, but it can keep the affected tubal and improve the chance of conception .