[1]郑华,张雁,郭宏霞*.不同治疗方案对异位妊娠所保留输卵管形态及功能影响的研究[J].中国计划生育和妇产科,2017,(1):51-54.
　ZHENG Hua,ZHANG Yan,GUO Hong-xia*.Effect of different treatment regimens on morphology and function of retained fallopian tube in ectopic pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2017,(1):51-54.
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不同治疗方案对异位妊娠所保留输卵管形态及功能影响的研究
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年1期
页码:
51-54
栏目:
论著与临床
出版日期:
2017-01-25

文章信息/Info

Title:
Effect of different treatment regimens on morphology and function of retained fallopian tube in ectopic pregnancy
作者:
郑华; 张雁; 郭宏霞*
北京市朝阳区妇幼保健院妇产科
Author(s):
ZHENG Hua;  ZHANG Yan; GUO Hong-xia*
Department of Obstetrics & Gynecology, Maternal and Child Health Hospital of Chaoyang District, Beijing 100021, P.R.China
关键词:
异位妊娠; 输卵管妊娠; 保守性治疗; 甲氨蝶呤; 妊娠结局
Keywords:
ectopic pregnancy; tubal pregnancy; conservative;  treatment; methotrexate; pregnancy outcome
摘要:
目的探讨药物保守治疗与腹腔镜保守性手术治疗对异位妊娠所保留输卵管形态及功能的影响。方法对北京市朝阳区妇幼保健院2013年1月至2015年6月间异位妊娠经药物保守治疗成功患者40例与腹腔镜保守性手术治疗20例的输卵管复通情况与再次妊娠情况及结局进行分析。治愈3个月后行子宫输卵管碘油造影检查，了解患侧输卵管通畅情况。结果药物保守治疗组患侧输卵管复通率为725 %(29/40)，而手术治疗组复通率为700 %(14/20)，两组比较差异无统计学意义(P>005)。药物保守治疗组40例中，16例于随访期内再次妊娠，2例为重复性异位妊娠，14例宫内妊娠，其中1例行辅助生殖技术，足月分娩8例；手术治疗组20例患者中，再次妊娠8例（其中3例行体外受精-胚胎移植术），1例为自然受孕后重复性异位妊娠，足月分娩5例。药物保守治疗组再次自然宫内妊娠率为325 %(13/40)，手术组自然宫内妊娠率20 %(4/20)，两组比较差异有统计学意义（P<005）。药物保守治疗组住院费用显著低于手术组，但住院时间明显长于手术组（P＜005)。结论传统中药方剂联合甲氨蝶呤药物治疗与腹腔镜保守性手术治疗有异曲同工的效果，临床实践中，如何选取具体治疗方法，还需要对满足两种保守治疗条件的患者进行具体分析，做到个体化治疗。
Abstract:
ObjectiveTo explore the effect of drug conservative therapy and laparoscopic conservative surgery on morphology and function of retained fallopian tube in ectopic pregnancy.MethodsFrom January 2013 to June 2015 patients with ectopic pregnancy in Beijing Maternal and Child Health Hospital of Chaoyang District were selected.40 cases were treated with drug conservative treatment and 20 cases were treated with laparoscopic conservative surgery.Analyze the condition of reoperation and re–pregnancy outcomes. 3 months later, uterine tubal iodine oil radiography examination was taken to understand the fallopian tube patency of the affected side.ResultsIn the drug conservative treatment group, the affected side fallopian tube patency rate was 725% (29/40), while the recovery rate was 70%(14/20)in the conservative surgery group. There was no significant difference between the two groups (P>005). Of the 40 cases in the drug conservative treatment group, 16 cases were of re–pregnancy in the follow-ups, 2 cases were of recurrent ectopic pregnancy, 14 cases were of intrauterine pregnancy with 1 case of assisted reproductive technology, 8 cases were of full-term delivery; Of the 20 patients in the surgery group, 8 cases were of re–pregnancy (3 cases underwent in vitro fertilization - embryo transfer), 1 case was of repeated ectopic pregnancy after natural pregnancy, 5 cases were of full-term delivery. The natural intrauterine pregnancy rate of the two groups were 325% (13/40) and 20% (4/20). The difference was statistically significant (P<005).ConclusionPrescription of traditional Chinese medicine combined with methotrexate and laparoscopic conservative surgery are different approaches with equally satisfactory results. Hospitalization expenses of the drug conservative treatment group were significantly lower than the surgery group with much longer length of hospitalization. Each treatment has its own merits. Specific analysis is needed to select specific treatment for patients who can be treated in both methods in clinical practice so that individual treatment can be achieved.

参考文献/References:

［1］岳晓燕，周应芳输卵管妊娠治疗现状与趋势 ［J］实用妇产科杂志，2002，18（3）：149-151 ［2］LI Jing-wei, JIANG Kai-lei, ZHAO Fu-jie. Fertility outcome analysis after surgical management of tubal ectopic pregnancy: a retrospective cohort study ［J］. BMJ Open, 2015, 5(9): e007339. ［3］BARNHART K, GOSMAN G, ASHBY R, et al. The medical management of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens［J］. Obstetrics and Gynecology, 2003, 101(4): 778-784. ［4］王彩霞，胡晴丽腹腔镜保守手术及药物保守治疗有生育需求的异位妊娠疗效观察 ［J］山东医药，2011，51（10）：98-99 ［5］杨丽华，苏莹，冷天艳未破裂型输卵管妊娠腹腔镜保守性手术和甲氨蝶呤治疗的比较研究 ［J］实用妇产科杂志，2012，28（11）：985-986 ［6］方素珍中西医结合与腹腔镜手术对输卵管妊娠治疗后的生殖评价 ［J］广东医学，2012，33（5）：700-701

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备注/Memo

备注/Memo:
北京市朝阳区2013年科技计划项目（项目编号: SF1320）
更新日期/Last Update: 2017-01-25