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目的探讨B超引导下经阴道或腹部穿刺注入甲氨蝶呤(MTX)和腹腔镜保守性手术治疗异位妊娠两者近远期治疗效果的比较。方法将98例患者分为经阴道或腹部穿刺注入MTX局部注射组(A组)和腹腔镜保守性手术治疗组(B组)进行比较,观察HCG、住院天数、费用、输卵管通畅、再次宫内妊娠、同侧异位妊娠情况。结果B组住院天数较A组短(P<0.01),A组住院费用较B组少(P<0.01),B组宫内妊娠较多,但差异无统计学意义(P>0.05),两组同侧异位妊娠差异无统计学意义(P>0.05)。结论腹腔镜下保守性手术治疗异位妊娠疗效较快,住院天数短,输卵管恢复功能相对较快,再次宫内妊娠机会稍高,而局部注射费用少,不需手术,虽输卵管恢复功能较长,但成功率较高易被患者接受,两种各有优势,值得应用。
Objective To investigate the short-term and long-term therapeutic effects of methotrexate (MTX) and laparoscopic conservative surgery for ectopic pregnancy undergoing B-ultrasound guided transvaginal or abdominal puncture. Methods 98 patients were divided into transvaginal or abdominal puncture injection of MTX local injection group (A group) and laparoscopic conservative surgery group (B group) were compared to observe the HCG, length of stay, cost, tubal patency, intrauterine Pregnancy, ipsilateral ectopic pregnancy. Results The hospitalization days in group B were shorter than those in group A (P <0.01), and the hospitalization costs in group A were less than those in group B (P <0.01). The intrauterine pregnancy in group B was more, but the difference was not statistically significant (P> 0.05) Group ipsilateral ectopic pregnancy difference was not statistically significant (P> 0.05). Conclusions Laparoscopic conservative surgery is effective in treating ectopic pregnancy with short days of hospitalization and rapid recovery of fallopian tube. The opportunity for intrauterine pregnancy is slightly higher, while the cost of local injection is less and surgery is not required. Although the function of tubal recovery is longer , But the higher success rate is easily accepted by patients, two have their own advantages, it is worth applying.