论文部分内容阅读
目的观察输卵管内注入高渗葡萄糖防治腹腔镜术后持续异位妊娠的效果。方法选择2014年4月—2016年5月收治的输卵管妊娠患者327例,随机分为葡萄糖组、甲氨蝶呤组、对照组各109例。三组均给予腹腔镜手术治疗。葡萄糖组术后采用50%葡萄糖液5 ml注入患侧输卵管残腔;甲氨蝶呤组术后采用甲氨蝶呤20 mg注入患侧输卵管残腔;对照组不给予任何药物。术后比较三组持续异位妊娠发生情况;对比三组术前及术后第1、3、7天β-HCG值;对比三组治疗期间不良反应发生情况。三组间计量资料比较采用单因素方差分析,两两比较采用LSD-t检验;异位妊娠发生率、不良反应发生率比较采用χ2检验;P<0.05为差异有统计学意义。结果术后葡萄糖组、甲氨蝶呤组持续异位妊娠发生率(1.83%、1.83%)均低于对照组(7.34%),比较差异有统计学意义(均P<0.05),葡萄糖组、甲氨蝶呤组持续异位妊娠发生率比较差异无统计学意义(均P>0.05)。与术前[(2 160.30±124.15)、(2 157.31±130.62)、(2 159.85±127.63)U/L]比较,术后第1、3、7天三组血β-HCG值均降低(均P<0.05);术后第1天三组血β-HCG值[(1 106.41±115.37)、(1 113.06±117.64)、(1 110.55±120.34)U/L]比较差异无统计学意义(均P>0.05);术后第3、7天葡萄糖组血β-HCG值[(379.25±60.37)、(72.56±10.38)U/L]较对照组[(550.27±60.32)、(220.58±60.79)U/L]降低(均P>0.05),葡萄糖组与甲氨蝶呤组血β-HCG值[(442.15±66.81)、(84.30±14.26)U/L]比较差异无统计学意义(均P>0.05)。高渗葡萄糖组、对照组均无不良反应发生;甲氨蝶呤组发生口腔溃疡2例、轻度骨髓抑制1例。结论高渗葡萄糖可预防腹腔镜术后持续异位妊娠的发生,且无不良反应,临床应用安全有效。
Objective To observe the effect of intraperitoneal infusion of hypertonic glucose on the prevention and treatment of ectopic pregnancy after laparoscopic surgery. Methods 327 patients with tubal pregnancy who were admitted from April 2014 to May 2016 were randomly divided into glucose group, methotrexate group and control group with 109 cases each. All three groups were given laparoscopic surgery. The patients in the glucose group were injected with 5 ml of 50% dextrose solution into the tubal residual cavity of the affected side. Methotrexate 20 mg was injected into the tubal cavity of the affected side after the operation in the methotrexate group. No drug was given in the control group. The incidences of ectopic pregnancy were compared between the three groups after operation. The β-HCG values of the three groups before and after operation were compared between the three groups. The incidence of adverse reactions was compared between the three groups during the treatment. The three groups of measurement data were compared using one-way analysis of variance, pairwise comparison using LSD-t test; ectopic pregnancy incidence, incidence of adverse reactions compared withχ2 test; P <0.05 was considered statistically significant. Results The incidences of persistent ectopic pregnancy (1.83%, 1.83%) in glucose group and methotrexate group were significantly lower than those in control group (7.34%, P <0.05) Methotrexate group continued ectopic pregnancy incidence was no significant difference (all P> 0.05). Compared with the preoperative [(2 160.30 ± 124.15), (2 157.31 ± 130.62), (2 159.85 ± 127.63) U / L] (P <0.05). There was no significant difference in the value of β-HCG between the three groups on the first postoperative day [(1 106.41 ± 115.37), (1 113.06 ± 117.64), (1105.5 ± 120.34) U / L (P <0.05). Compared with the control group [(550.27 ± 60.32), (220.58 ± 60.79), P < U / L] (all P> 0.05). There was no significant difference of β-HCG between glucose group and methotrexate group [(442.15 ± 66.81), (84.30 ± 14.26) U / L] > 0.05). There were no adverse reactions in hypertonic glucose group and control group, 2 cases of oral ulcer in methotrexate group and 1 case of mild myelosuppression. Conclusion Hypertonic glucose can prevent the occurrence of persistent ectopic pregnancy after laparoscopic surgery without any adverse reactions, and its clinical application is safe and effective.