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目的探究腹腔镜下局部注射甲氨蝶呤治疗输卵管妊娠对卵巢功能及输卵管再通的影响。方法 78例输卵管妊娠患者,依据治疗方式的不同分成对照组与研究组,各39例。对照组行腹腔镜下输卵管开窗取胚术,研究组于对照组基础上加以甲氨蝶呤局部注射治疗。比较两组不同时间血β-人绒毛膜促性腺激素(β-HCG)水平、雌二醇(E_2)、卵泡刺激素(FSH)与黄体生成素(LH)水平及输卵管再通情况。结果研究组患者术后1、4、14 d的血β-HCG水平均低于对照组,差异均具有统计学意义(t=5.0513、7.1651、18.0455,P<0.05)。术后3个月,研究组患者的E2、FSH、LH水平与对照组比较,差异均无统计学意义(P>0.05)。术后3个月,研究组通畅率66.67%高于对照组43.59%,差异具有统计学意义(P<0.05)。结论输卵管妊娠采取腹腔镜下局部注射甲氨蝶呤治疗,可有助于保护患者卵巢功能,促进疗效提高,患者预后改善,可推广。
Objective To investigate the effect of laparoscopic local injection of methotrexate on ovarian function and tubal recanalization after tubal pregnancy. Methods 78 cases of tubal pregnancy patients, divided into control group and study group, 39 cases in each group according to different treatment methods. The control group underwent laparoscopic tubal fenestration, the study group in the control group on the basis of methotrexate local injection therapy. The levels of β-HCG, E2, FSH, LH and tubal recanalization were compared between two groups at different time points. Results The levels of β-HCG in the study group were lower than those in the control group on the 1st, 4th, 14th day after operation (t = 5.0513,7.1651,18.0455, P <0.05). At 3 months after operation, the levels of E2, FSH and LH in the study group were not significantly different from those in the control group (P> 0.05). Three months after operation, the study group patency rate was 66.67% higher than the control group 43.59%, the difference was statistically significant (P <0.05). Conclusion Tubal pregnancy by laparoscopic local injection of methotrexate treatment can help to protect patients with ovarian function, and promote the improvement of efficacy, improve the prognosis of patients, can be promoted.