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目的观察腹腔镜手术联合药物治疗输卵管妊娠的效果。方法回顾性分析该院收治的输卵管妊娠患者56例,采用腹腔镜下的保守性手术,在患侧输卵管系膜内注射垂体后叶素6U,输卵管挤压法或输卵管开窗术法取出妊娠物,并在输卵管系膜内注射氨甲蝶呤(MTX)25mg治疗。术后通过复查尿妊娠试验及血β-h CG;在患者月经恢复3个月的3~7d内,门诊行输卵管通液术(共3次)。观察治疗效果。结果 56例手术均获成功,术后复诊患者血β-h CG平均14d降至正常水平。术后第4、5个月输卵管通液失败5例占8.9%。结论腹腔镜保守性手术联合药物治疗输卵管妊娠可有效地杀死残存的绒毛及蜕膜组织,避免持续性异位妊娠的发生,增加患者生育的机会,安全有效,容易掌握。
Objective To observe the effect of laparoscopic surgery combined with drug treatment of tubal pregnancy. Methods Retrospective analysis of 56 cases of tubal pregnancy admitted to the hospital, the use of laparoscopic conservative surgery in the ipsilateral tubal injection of pituitary vasopressin 6U, tubal extrusion or tubal fenestration removed pregnancy , And in the fallopian tube mesangial injection of methotrexate (MTX) 25mg treatment. Postoperative urine pregnancy test by review and blood β-h CG; in patients with menstrual recovery 3 months 3 ~ 7d, outpatient line tubal fluid (3 times). Observe the effect of treatment. Results All the 56 surgeries were successful. The mean β-h CG in the follow-up patients dropped to normal after 14 days. In the 4th and 5th months after operation, tubal failure occurred in 5 cases (8.9%). Conclusion Laparoscopic conservative surgery combined with drug treatment of tubal pregnancy can effectively kill the residual villi and decidua, avoid the occurrence of persistent ectopic pregnancy, increase the chances of childbirth, safe and effective, easy to grasp.