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目的:探讨甲氨蝶呤(MTX)和垂体后叶素用于腹腔镜治疗输卵管妊娠的临床效果。方法:对未破裂型输卵管妊娠采取腹腔镜开窗取胚+局部注射MTX保守手术治疗患者148例,按术中是否联合使用垂体后叶素分两组,Ⅰ组(观察组)应用MTX+垂体后叶素在妊娠输卵管病灶基底部注射74例;Ⅱ组(对照组)单用MTX 74例。观察两组术中出血量、手术时间及对输卵管病灶电凝例数、术后血hCG下降、持续性异位妊娠等情况。结果:两组比较,Ⅰ组术中出血量明显少、手术时间明显缩短、很少用电凝止血,差异有统计学意义(P<0.01);术后血hCG下降、持续性异位妊娠发生情况,两组差异无统计学意义(P>0.05)。结论:腹腔镜异位妊娠开窗手术中应用甲氨碟呤+垂体后叶素治疗效果明显,能有效减少电凝止血对输卵管组织损伤、不增加持续性异位妊娠发生率。
Objective: To investigate the clinical effect of methotrexate (MTX) and vasopressin in the treatment of tubal pregnancy by laparoscopy. Methods: 148 cases of unruptured tubal pregnancy with laparoscopic fenestration and local injection of MTX conservative surgery were divided into two groups according to whether pituitrin was used intraoperatively. In group Ⅰ (observation group), MTX + Semen in tubal pregnancy tubal lesions in the basal injection of 74 cases; Ⅱ group (control group) alone MTX 74 cases. The blood loss, operation time and the number of coagulation in tubal lesion, the decrease of blood hCG and persistent ectopic pregnancy were observed in two groups. Results: Compared with the two groups, the intraoperative blood loss in group Ⅰ was significantly less and the operation time was significantly shortened. The electrosurgical coagulation was seldom used, the difference was statistically significant (P0.01); the blood hCG decreased and persistent ectopic pregnancy occurred The difference between the two groups was not statistically significant (P> 0.05). CONCLUSION: Methedrine + pituitrin is effective in the fenestration of laparoscopic ectopic pregnancy, which can effectively reduce the damage of tubal tissue by electrocision hemostasis without increasing the incidence of persistent ectopic pregnancy.