论文部分内容阅读
目的评价腹腔镜下输卵管妊娠保守手术治疗的临床疗效。方法选择合浦县人民医院妇科2014年1月—2015年9月输卵管妊娠患者,根据治疗方法分为两组,手术组45例行腹腔镜下输卵管妊娠保守手术,药物组40例行甲氨蝶呤联合米非司酮药物保守治疗,比较两组住院时间、治疗前及出院时血β-h CG水平、血β-h CG下降至正常时间、术后输卵管通畅率;所有患者均随访至2016年11月,比较两组宫内妊娠率、再次异位妊娠率。计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果手术组治疗有效率为97.78%,药物组有效率为95.00%,对比差异无统计学意义(P>0.05)。手术组入院时血β-h CG水平明显高于药物组,出院时血β-h CG水平明显低于药物组,对比差异有统计学意义(P<0.05)。手术组平均住院时间、血β-h CG下降至正常时间均显著短于药物组,对比差异有统计学意义(P<0.05)。手术组患侧输卵管通畅率为80.00%,药物组为60.00%,对比差异有统计学意义(P<0.05)。所有患者均随访至2016年11月,平均随访时间(25.2±6.3)个月,手术组宫内妊娠率为66.67%,药物组为42.50%,对比差异有统计学意义(P<0.05)。两组异位妊娠率比较差异无统计学意义(P>0.05)。结论输卵管妊娠患者行腹腔镜保守手术较药物保守治疗具有明显的优势,是适合有生育要求女性的安全、可靠的方法。
Objective To evaluate the clinical efficacy of laparoscopic conservative surgery for tubal pregnancy. Methods Hepu County People’s Hospital gynecological January 2014 - September 2015 tubal pregnancy patients were divided into two groups according to the treatment method, the operation group 45 cases of laparoscopic tubal pregnancy conservative surgery, the drug group of 40 patients methotrexate In combination with the conservative treatment of mifepristone, the length of hospital stay, the level of blood β-h CG and the level of β-h CG in blood serum before and after discharge were compared to the normal time and tubal patency rate after operation. All the patients were followed up until 2016 November, comparing the two groups of intrauterine pregnancy rate, ectopic pregnancy rate again. Measurement data using t test, count data using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The effective rate of the operation group was 97.78%, and the effective rate of the drug group was 95.00%. There was no significant difference between the two groups (P> 0.05). The level of β-h CG in the operation group was significantly higher than that in the drug group. The level of β-h CG in the discharge group was significantly lower than that in the drug group (P <0.05). The mean length of stay in the operation group and the decrease of the blood β-h CG to normal time were significantly shorter than those in the drug group, with significant difference (P <0.05). The tubal patency rate in the operation group was 80.00% and that in the drug group was 60.00%, the difference was statistically significant (P <0.05). All patients were followed up until November 2016 with an average follow-up time of (25.2 ± 6.3) months. The intrauterine pregnancy rate was 66.67% in the operation group and 42.50% in the drug group. The difference was statistically significant (P <0.05). There was no significant difference in ectopic pregnancy between the two groups (P> 0.05). Conclusions Laparoscopic conservative surgery has obvious advantages over conservative treatment in tubal pregnancy patients and is a safe and reliable method for women with fertility requirements.