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目的探讨甲氨蝶呤(methotrexate,MTX)作为输卵管妊娠保守性手术辅助药物在预防持续性宫外孕(persistent ectopic pregnancy,PEP)中的临床效果。方法选择2009年12月—2011年12月收治的输卵管妊娠患者128例,随机分为对照组和观察组各64例,对照组给予保守性手术治疗,观察组在对照组的基础上给予MTX 20 mg注入患侧输卵管残腔。比较两组患者术后PEP的发生率和血β-HCG下降情况。结果 PEP发生率对照组14.1%,观察组1.6%,两组比较差异有统计学意义(P<0.05);两组术后1、3 d血β-HCG水平比较差异无统计学意义(P>0.05),术后7、12 d血β-HCG水平两组比较差异有统计学意义(P<0.05)。结论输卵管妊娠保守性手术中加用MTX可以有效预防PEP的发生,值得临床推广。
Objective To investigate the clinical efficacy of methotrexate (MTX) as a conservative adjuvant for tubal pregnancy in the prevention of persistent ectopic pregnancy (PEP). Methods 128 patients with tubal pregnancy who were treated from December 2009 to December 2011 were randomly divided into control group and observation group with 64 cases each. The control group was given conservative surgery. The observation group was given MTX 20 mg into the affected tubal residual cavity. The incidence of postoperative PEP and the decline of serum β-HCG in both groups were compared. Results The incidence of PEP was 14.1% in the control group and 1.6% in the observation group, with significant difference between the two groups (P <0.05). There was no significant difference in blood β-HCG levels between the two groups at 1 and 3 days after operation (P> 0.05). The blood β-HCG levels at 7 and 12 days after operation were significantly different between the two groups (P <0.05). Conclusions The conservative treatment of tubal pregnancy with MTX can effectively prevent the occurrence of PEP, is worth clinical promotion.