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目的:探讨腹腔镜下注射甲氨蝶呤对异位妊娠病灶清除的临床疗效。方法:选取2007年1月～2009年5月于该院进行治疗的84例异位妊娠患者为研究对象,将其随机分为对照组(腹腔镜下异位妊娠术组)42例和观察组(腹腔镜下病灶清除联合甲氨蝶呤局部注射组)42例,后将两组患者的手术时间、出血量、肛门排气时间、住院时间、并发症发生率、再孕率及治疗前、治疗后3天及7天的血清β-HCG、P、VEGF(血管内皮生长因子)及PAPP-A(妊娠相关蛋白)水平进行统计及比较。结果:两组患者手术时间、出血量、肛门排气时间比较,P值均>0.05,均无统计学差异,而观察组的住院时间短于对照组,并发症发生率低于对照组,再孕率高于对照组,治疗后3天及7天的血清β-HCG、P、VEGF及PAPP-A水平均低于对照组,P值均<0.05,均有统计学差异。结论:腹腔镜下注射甲氨蝶呤对异位妊娠病灶清除的临床疗效较佳,安全性也较高,在降低血清β-HCG、P、VEGF及PAPP-A水平方面优势明显。
Objective: To investigate the clinical effect of laparoscopic methotrexate injection in ectopic pregnancy. Methods: A total of 84 patients with ectopic pregnancy treated in our hospital from January 2007 to May 2009 were selected and randomly divided into control group (laparoscopic ectopic pregnancy group) 42 cases and observation group (Laparoscopic focal debridement combined with methotrexate local injection group) 42 cases, the two groups of patients after surgery time, bleeding, anal exhaust time, hospital stay, the incidence of complications, the rate of pregnancy and pregnancy before pregnancy, The levels of serum β-HCG, P, VEGF (vascular endothelial growth factor) and PAPP-A (pregnancy-related protein) were measured and compared at 3 days and 7 days after treatment. Results: There was no significant difference in the operation time, bleeding volume and anal exhaust time between the two groups (P> 0.05), while the length of stay in the observation group was shorter than that in the control group, and the incidence of complications was lower than that in the control group The pregnancy rates were higher than those of the control group. The levels of serum β-HCG, P, VEGF and PAPP-A at 3 days and 7 days after treatment were both lower than those in the control group (P <0.05). Conclusion: Methotrexate laparoscopic removal of ectopic pregnancy lesions with better clinical efficacy, safety is also high, in reducing the serum levels of β-HCG, P, VEGF and PAPP-A has obvious advantages.