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目的:探讨中药预防输卵管妊娠腹腔镜保守性手术后持续性异位妊娠(PEP)的疗效。方法:将2010年1月-2013年1月百色市田东县中医医院210例行腹腔镜保守性手术的输卵管妊娠患者随机分成A、B、C 3组,A组70例,术后6 h起服用中药组方,连用5 d;B组70例,采用MTX20 mg术中注入输卵管妊娠病灶下输卵管浆肌层及系膜内;C组70例,单纯腹腔镜手术治疗,观察比较3组患者的治疗情况。结果:A组、B组各有2例发生PEP,发生率为1.43%,C组11例发生PEP,发生率为8.57%,A组和B组的发生率明显低于C组,差异具有统计学意义(P<0.05)。A组和B组手术后72 h血β-HCG下降幅度明显大于C组(P<0.05)。A组和B组手术后血β-HCG恢复至正常的时间比C组的短,差异具有统计学意义(P<0.05)。术后3组患者最早排气时间A组与C组比较,差异具有统计学意义(P<0.05);B组的不良反应明显高于A、C两组,差异具有统计学意义(P<0.05)。结论:输卵管妊娠腹腔镜保守性手术治疗后,术中应用MTX20 mg术中注入输卵管妊娠病灶下输卵管浆肌层及系膜内和术后口服中药组方两种方法均能降低PEP的发生率,而且术后应用中药治疗的胃肠功能恢复快,不良反应更少、安全。
Objective: To investigate the efficacy of traditional Chinese medicine in preventing persistent ectopic pregnancy (PEP) after laparoscopic conservative surgery of tubal pregnancy. Methods: 210 patients with tubal pregnancy undergoing laparoscopic conservative surgery from January 2010 to January 2013 in Tiandong Chinese Medicine Hospital of Baise City were randomly divided into A, B and C groups. A group of 70 patients, 6 h after operation The patients in group C received 70 mg of MTX 20 mg intra-operatively and were injected into the tubal myometrium and mesangial membrane of tubal pregnancy in 70 cases of group C. The patients in group C received laparoscopic surgery only. The treatment. Results: The incidence of PEP in group A and group B was 1.43%, and in group C 11 cases were PEP, the incidence was 8.57%. The incidence of group A and group B was significantly lower than that of group C Significance (P <0.05). The decrease of serum β-HCG in group A and group B at 72 h after operation was significantly greater than that in group C (P <0.05). The blood β-HCG levels returned to normal in group A and group B after operation were shorter than those in group C, with significant difference (P <0.05). There was significant difference between group A and group C (P <0.05). The adverse reactions in group B were significantly higher than those in group A and C (P <0.05) ). Conclusions: After conservative treatment of tubal pregnancy with laparoscopy, intraoperative application of MTX20 mg intraoperative tubal injection of tubal lesions within the tubal and intramembranous and postoperative oral Chinese medicine group both ways can reduce the incidence of PEP, And postoperative application of traditional Chinese medicine to restore gastrointestinal function faster, less adverse reactions, safety.