输卵管妊娠保守治疗方法探讨

输卵管妊娠保守治疗方法探讨

目的探讨输卵管妊娠的保守治疗方法。方法选取本院2006年1月～2014年12月收治的90例未破裂和未流产型输卵管妊娠患者作为研究对象，随机分为试验组、腹腔镜手术组和药物保守治疗组，各30例。试验组采用孕囊穿刺注药法配伍中药口服治疗，腹腔镜手术组采用腹腔镜保守手术治疗，药物保守治疗组采用药物保守治疗。比较三组的治愈率、β-绒毛膜促性腺激素（β-HCG）降至正常时间、异位包块消失时间、患侧输卵管通畅率、治疗费用。结果试验组、腹腔镜手术组、药物保守治疗组的治愈率分别为100%、100%、90%。试验组与腹腔镜手术组的血β-HCG下降至正常时间显著短于药物保守治疗组，差异有统计学意义（P＜0.05）。试验组与腹腔镜手术组的血β-HCG下降至正常时间比较，差异无统计学意义（P>0.05）。腹腔镜手术组的异位包块消失时间短于试验组及药物保守治疗组，差异有统计学意义（P＜0.05）。试验组的异位包括消失时间短于药物保守治疗组，差异有统计学意义（P＜0.05）。试验组的患侧输卵管通畅率高于腹腔镜手术组及药物保守治疗组，差异有统计学意义（P＜0.05）。腹腔镜手术组与药物保守治疗组的输卵管通畅率比较，差异无统计学意义（P>0.05）。腹腔镜手术组的治疗费用高于试验组和药物保守治疗组，差异有统计学意义（P＜0.05）。试验组和药物保守治疗组的治疗费用比较，差异无统计学意义（P>0.05）。结论孕囊穿刺抽吸注药配伍中药治疗未破裂和未流产型输卵管妊娠患者的杀胚效果明显，能明显缩短包块消失时间，提高患侧输卵管通畅率，治疗费用低，对有生育要求未破裂及未流产型的输卵管妊娠患者意义重大。

[Abstract]Objective To explore the conservative treatment method of tubal pregnancy.Methods 90 patients with unruptured and no abortion tubal pregnancy from January 2006 to December 2014 in our hospital were selected and randomly divided into the experimental group，the laparoscopic surgery group and the drug conservative treatment group，30 cases in each group.The experimental group was treated with gestational sac puncture and injection of medicine method combined with oral traditional Chinese medicine，the laparoscopic surgery group was treated with laparoscopic surgery，the drug conservative treatment group was treated with drug conservative treatment.The cure rate，the time of β-HCG decreased to the normal，the disappearance time of ectopic mass，the tubal patency rate of the affected side，the cost of treatment among three groups was compared respectively.Results The cure rates of the three groups were 100%，100% and 90% in the experimental group，the laparoscopic surgery group and the drug conservative treatment group.The time of β-HCG decreased to the normal in the experimental group and the laparoscopic surgery group was shorter than that in the drug conservative treatment group，with significant difference （P＜0.05）.There was no significant difference in the time of β-HCG decreased to the normal between the experimental group and the laparoscopic surgery group （P>0.05）.The disappearance time of ectopic mass in the laparoscopic surgery group was shorter than that in the experimental group and the drug conservative treatment group，with significant difference （P＜0.05）.The disappearance time of ectopic mass in the experimental group was shorter than that in

the drug conservative treatment group，with significant difference （P＜0.05）.The tubal patency rate of the affected side in the experimental group was higher than that in the laparoscopic surgery group and the drug conservative treatment group，with significant difference （P＜0.05）.There was no significant difference in the tubal patency rate of the affected side between the laparoscopic surgery group and the drug conservative treatment group （P>0.05）.The cost of treatment in the laparoscopic surgery group was higher than that in the experimental group and the drug conservative treatment group，with significant difference （P＜0.05）.There was no significant difference in the cost of treatment between the laparoscopic surgery group and the drug conservative treatment group （P>0.05）.Conclusion The effect of killing embryo of gestational sac aspiration injection of medicine method combined with oral traditional Chinese medicine in the treatment of unruptured and not abortion tubal pregnancy patients is obvious，which can significantly shorten the mass disappearance time，improve the tubal patency rate of the affected side，and the treatment cost is low，it is of great significance to the patients with fertility requirement of unruptured and no abortion tubal pregnancy.[Key words]Tubal pregnancy；Gestational sac puncture and injection；Conservative treatment of traditional Chinese medicine；Laparoscopic conservative surgery

随着β-人绒毛膜促性腺激素（β-HCG）检测水平和B超诊断技术的提高和广泛应用，异位妊娠的早期诊断已成为可能，这为有生育要求的未破裂和未流产型输卵管妊娠的保守治疗提供了时机。异位妊娠90%位于输卵管[1]，治疗方法有手术、药物、介入等多种，药物治疗主要以甲氨蝶呤（MTX）为主[2]。为寻求高效、快速、安全的保守治疗方法，本研究选取本院的90例未破裂、未流产型输卵管妊娠患者作为研究对象，采用孕囊穿刺抽吸注药后配伍中药口服[3]、静脉滴注或肌内注射MTX后配伍中药口服[4]和腹腔镜下保守手术[5]等三种不同保守治疗方法进行治疗，探讨其效果。

1资料与方法

1.1一般资料

选取本院2006年1月～2014年12月收治的90例未破裂和未流产型输卵管妊娠患者作为研究对象，年龄18～40岁，平均27.5岁；未婚未产者68例，有人工流产或生产史者22例。将入选患者随机分为试验组、腹腔镜手术组和药物保守治疗组，各30例。三组的年龄、生育情况、人工流产情况等一般资料比较，差异无统计学意义（P>0.05），具有可比性。

1.2纳入标准

血β-HCG0.05）。腹腔镜手术组的异位包块消失时间短于试验组及药物保守治疗组，差异有统计学意义（P＜0.05）。试验组的异位包括消失时间短于药物保守治疗组，差异有统计学意义（P＜0.05）。