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浅议黄体剥除预防持续性异位妊娠的临床问题 |
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【摘要】 目的：观察对比黄体剥除术与甲氨喋呤(methotrexate,MTX)辅助防治输卵管妊娠腹腔镜保守性手术后持续性异位妊娠(persistent ectopic pregnancy,PEP)的疗效。 方法：有生育要求的异位妊娠患者共86例，随机分成观察组44例，对照组42例。观察组腹腔镜下行胚胎清除术同时行黄体剥除术，对照组胚胎清除后局部注射甲氨碟呤20mg，未行黄体剥除。两组患者均于术前及术后24小时、72小时、7天、12天检测血βhCG值，并观察其毒副反应。 结果：观察组发生PEP1例(2.27%)，对照组2例(4.76%)，差异无显著性意义(χ2=0.395，P>0.05);两组术后24小时血βhCG值较术前明显下降(P<0.01)，但两组间差异无显著性意义(P>0.05);术后72小时、7天血βhCG值两组间差异无显著性意义(P>0.05)，但12天两组间比较差异有非常显著性意义，对照组明显高于观察组(P<0.01);且对照组毒副反应明显多于观察组。结论：黄体剥除术防治PEP的疗效与MTX相同，但黄体剥除术副作用小。
【关键词】 持续性异位妊娠 黄体剥除 腹腔镜保守性手术 甲氨喋呤
Clinical Study on Enucleation of Corpus Luteum to Prevent Persistent Ectopic Pregnancy XU Qun.Wenzhou Medical College,Wenzhou(325000),China
Abstract Objective:To compare the therapeutic efficacy of enucleation of corpus luteum to methotrexate adjuvant therapy on preventing persistent ectopic pregnancy(PEP) after laparoscopic conservative operation for tubal pregnancy.Methods:Eightsix patients with ectopic pregnancy who were eager to have a baby were randomly divided to observation group (n=44) and control group (n=42).Combined with laparoscopic removal of embryo,enucleation of corpus luteum was performed in the observation group and methotrexate of 20 mg was injected in the control group. The level of βhCG was measured before operation and on day 1,3,7 and 12 after operation,and adverse events were observed.Results:The&nbs[1] [2] [3] [4] 下一页
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