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目的:比较腹腔镜保守手术术中注射氨甲喋呤与术后口服米非司酮治疗异位妊娠的疗效及安全性。方法:将85例异位妊娠患者随机分为观察组43例和对照组42例,2组均行腹腔镜保守性手术治疗。观察组术后6小时开始口服米非司酮50mg,1天2次,连服3天,对照组术中使用氨甲喋呤(MTX)30mg病灶局部注射。比较2组手术时间、术后副反应、血清β-HCG的变化、持续性异位妊娠(PEP)发生率、术后患侧输卵管的通畅程度。结果:观察组手术时间、术后副反应均少于对照组,术后血β-HCG降至正常时间较短,发生PEP机率低,而2组术后72小时血β-HCG值、输卵管复通率无差异。结论:腹腔镜保守手术联合米非司酮较术中注射氨甲喋呤具有手术时间短、副反应小的优势,而且完全能预防PEP。
Objective: To compare the efficacy and safety of methotrexate and laparoscopic oral mifepristone in the treatment of ectopic pregnancy after laparoscopic conservative surgery. Methods: Eighty-five patients with ectopic pregnancy were randomly divided into observation group (n = 43) and control group (n = 42). All patients underwent laparoscopic conservative surgery. The observation group began oral mifepristone 50 mg 6 hours after operation, twice a day for 3 consecutive days. The control group received local injection of methotrexate (MTX) 30 mg intra-operatively. The operative time, postoperative side effects, changes of serum β-HCG, the incidence of persistent ectopic pregnancy (PEP) and the tubal patency in the affected side were compared between the two groups. Results: The operation time and postoperative adverse reactions in the observation group were less than those in the control group. The postoperative β-HCG decreased to normal time and the incidence of PEP was low. The values of β-HCG, No difference in pass rates. Conclusions: Laparoscopic conservative operation combined with mifepristone has the advantages of shorter operation time and less side effects than methotrexate, and can completely prevent PEP.