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目的通过研究腹腔镜下插管微泵缓释甲氨蝶呤治疗未破裂型输卵管妊娠的临床应用情况及其临床价值。方法60例未破裂型输卵管妊娠患者,采用腹腔镜下插管微泵缓释甲氨蝶呤治疗(实验组)和甲氨蝶呤注射保守性治疗(对照组)各30例,治愈后一段时期内进行宫腔输卵管碘油造影检查。观察两种治疗方法的血绒毛膜促性腺激素(h CG)值、包块、输卵管形态及其他生命体征,继而比较两种治疗方法的疗效、住院情况及输卵管复通率,探讨腹腔镜下插管微泵缓释甲氨蝶呤治疗未破裂型输卵管妊娠的可行性。结果实验组治疗成功率为86.67%(26/30),对照组为73.33%(22/30),差异具有统计学意义(P<0.05);实验组β-h CG转阴时间、住院时间明显短于对照组,差异有统计学意义(P<0.05);实验组术后患侧输卵管复通26例86.67%(26/30),对照组20例56.67%(17/30),差异具有统计学意义(P<0.05)。结论腹腔镜下插管微泵缓释甲氨蝶呤治疗与甲氨蝶呤注射保守性治疗都能治疗未破裂型输卵管妊娠,但是前者的治疗效果更好,住院时间也更短,更有利于恢复患者的输卵管通畅,尤其β-绒毛膜促性腺激素(h CG)>2 000 U/L,更具有一定的临床价值。
Objective To study the clinical application and clinical value of laparoscopic micropipetration with methotrexate in the treatment of unruptured tubal pregnancy. Methods Sixty patients with unruptured tubal pregnancy were treated with laparoscopic micropipette slow-release methotrexate (experimental group) and methotrexate-injected conservative treatment group (control group) with 30 cases each. After a period of cure Intrauterine tubal lipiodol contrast examination. To observe the value of hCG, mass, fallopian tube and other vital signs of the two treatment methods, and then compare the curative effect, hospitalization and tubal recanalization rate of the two treatment methods to explore the value of laparoscopic insertion The feasibility of sustained - release methotrexate tube micropipettes in the treatment of unruptured tubal pregnancy. Results The success rate of treatment was 86.67% (26/30) in experimental group and 73.33% (22/30) in control group, the difference was statistically significant (P <0.05). The β-h CG negative time and hospitalization time in experimental group were significantly The difference was statistically significant (P <0.05). In the experimental group, 26 cases were 86.67% (26/30) with contralateral fallopian tube recanalization and 56.67% (17/30) in the control group, the difference was statistically significant Significance (P <0.05). Conclusions Laparoscopic catheter microparticle slow release methotrexate and methotrexate injection are both conservative treatment of tubal unruptured tubal pregnancy, but the former treatment is better, shorter hospital stay, and more conducive to Recovery of tubal patency, especially β-chorionic gonadotropin (hCG)> 2000 U / L, more of a certain clinical value.