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目的观察探讨甲氨蝶呤预防持续性异位妊娠的临床疗效,总结其临床应用价值。方法选取我院2009年6月至2011年6月44例异位妊娠的患者,随机分成观察组和对照组各22例,均在腹腔镜下行胚胎清除术,观察组在术中局部使用甲氨蝶呤治疗,对照组术后局部使用甲氨蝶呤,观察比较两组疗效、持续性异位妊娠(PEP)、毒副反应。结果观察组PEP0例,毒副反应1例,总有效率为95.5%;对照组PEP1例,毒副反应5例,总有效率为90.9%,两组疗效及PEP发生率比较差异无统计学意义(P>0.05);两组毒副反应比较差异有统计学意义(P<0.05)。结论甲氨蝶呤预防持续性异位妊娠的临床疗效显著,能够迅速终止妊娠同时迅速降低血中β-HCG水平,不管术中还是术后注射甲氨蝶呤皆能有效降低PEP发生,但术中注射的毒副反应小,安全可靠,具有重要的临床应用价值。
Objective To investigate the clinical efficacy of methotrexate in the prevention of persistent ectopic pregnancy and to summarize its clinical value. Methods Forty-four patients with ectopic pregnancy in our hospital from June 2009 to June 2011 were randomly divided into observation group (22 cases) and control group (22 cases), underwent laparoscopic biopsy. The patients in the observation group were treated with methotrexate In the control group, the use of methotrexate locally was observed. The curative effect, persistent ectopic pregnancy (PEP) and side effects were observed and compared. Results In the observation group, there were 0 cases of PEP and 1 case of toxic and side effects, the total effective rate was 95.5%. In the control group, 1 case of PEP and 5 cases of toxic and side effects, the total effective rate was 90.9%. There was no significant difference in the curative effect and PEP incidence between the two groups (P> 0.05). There was significant difference between the two groups in the side effects (P <0.05). Conclusion Methotrexate is effective in preventing persistent ectopic pregnancy. It can terminate pregnancy rapidly and rapidly decrease β-HCG level in blood. Methotrexate can effectively reduce the incidence of PEP whether intraoperative or postoperative. In the injection of toxic side effects, safe and reliable, has important clinical value.