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目的:探讨腹腔镜保守手术和甲氨蝶呤联合米非司酮治疗异位妊娠的临床疗效及应用价值。方法:将2011年1月至2013年11月在我院确诊的并可行保守治疗的70例异位妊娠患者随机分为对照组(n=34)和研究组(n=36),分别以甲氨蝶呤联合米非司酮治疗和采用腹腔镜保守手术,治愈后4个月行宫腔输卵管碘油造影检查。比较两组的疗效、住院情况及输卵管复通率。结果:两组均治愈,研究组输卵管复通率明显高于对照组(86.11%vs 64.70%,P<0.05),住院费用显著高于对照组(7823.08±263.15元v8 3869.46±195.26元,P<0.05),住院时间显著短于对照组(7.18±0.93 d vs 22.45±6.51 d,P<0.05)。研究组胃肠道反应发生率低于对照组。结论:两种方法均能取得较好疗效,甲氨蝶呤联合米非司酮治疗费用低,患者无手术风险;腹腔镜保守手术治疗有较高的输卵管复通率及较少的住院天数;胃肠道反应发生率低,更有利于恢复患者的输卵管通畅。
Objective: To investigate the clinical efficacy and clinical value of laparoscopic conservative surgery and methotrexate combined with mifepristone in the treatment of ectopic pregnancy. Methods: Seventy patients with ectopic pregnancy, diagnosed in our hospital from January 2011 to November 2013 and who were conservatively treated, were randomly divided into control group (n = 34) and study group (n = 36) Methotrexate combined with mifepristone treatment and laparoscopic conservative surgery, cured 4 months after uterine tubal lipiodol contrast examination. Efficacy, hospitalization and tubal recurrence rate were compared between the two groups. Results: The two groups were cured. The tubal recanalization rate in the study group was significantly higher than that in the control group (86.11% vs 64.70%, P <0.05), and hospitalization expense was significantly higher than that in the control group (7823.08 ± 263.15 yuan vs 3869.46 ± 195.26 yuan, P < 0.05). The length of hospital stay was significantly shorter than that of the control group (7.18 ± 0.93 days vs 22.45 ± 6.51 days, P <0.05). The incidence of gastrointestinal reactions in the study group was lower than that in the control group. CONCLUSION: Both of the two methods can achieve better curative effect. Methotrexate combined with mifepristone has a lower cost and no surgical risk. Laparoscopic conservative surgery has a higher tubal recurrence rate and fewer days of hospitalization. The incidence of gastrointestinal reactions is low, more conducive to the restoration of tubal patency in patients.