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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:

03

期数:

2003年4期

页码:

323-324

栏目:

出版日期:

2003-04-30

文章信息/Info

Title:

Methotrexate injection by hysteroscopic tubal catheterization in the treatment of unruptured tubal pregnancy

作者:

马利国　 夏震　 陈递林　 杨菊芳　 钟燕青

深圳市人民医院,暨南大学医学院附属二院妇科,深圳,518020

Author(s):

Ma Liguo; Xia Zhen;  Chen Dilin; et al.

Department ofObstetrics and Gynecology,Shenzhen People’sHospital,Shenzhen518020,China

关键词:

宫腔镜;  异位妊娠;  甲氨蝶呤;  绒毛膜促性腺激素类

Keywords:

Hysteroscopy; 　Ectopic Pregnancy; 　MTX; 　HCG

分类号:

R713.8

文献标志码:

A

摘要:

目的评价在电视宫腔镜引导下输卵管插管局部注入甲氨蝶呤(MTX)治疗稳定型输卵管妊娠的近期效果,探讨影响该方法疗效的因素. 方法对2000年10月～2002年9月稳定型输卵管妊娠82例,在宫腔镜引导下输卵管插管注射MTX 20 mg(10ml),观察临床效果及副作用.对用药后72h血清β-HCG下降＜50% 者重复用药一次. 结果临床总治愈率82.9 %(68/82) ,单次给药者临床治愈率72.0 %(59/82).治愈时间(10±4.9)天.逐步回归分析显示:注药时药物返流、给药后72h血清β-HCG下

Abstract:

Objective　To evaluate the short-term effects of methotrexate (MTX) injection by hysteroscopic tubal catheterization for unruptured tubal pregnancy, and to investigate factors influencing curative effects of such approach.　Methods　A total of 82 patients with unruptured tubal pregnancy underwent injection of MTX 20 mg (10ml) by hysteroscopic tubal catheterization from October 2000 to September 2002. Clinical efficiency and side effectswere recorded. After administration for 72 hours, in case serumβ-HCG level had dropped less than 50 percent, a second injection ofMTXwas given.　Results　The total cure rate was 82·9% (68/82), and 72·0% (59/82) of the patients were cured clinically with the first administration of MTX, with the length of hospitalization being (10±4·9) days. Statistically, the drug re- flux at injection, the declining level ofβ-HCG after administration, and the serum level ofβ-HCG≥4000 mIu/ml before administration significantly influenced the curative effects (P=0·000,P=0·001,P=0·032, respectively). No side effectswere found in this study. Out of the 65 cured patients followed up for2 months,57 (87·7%) got normal menstruation.　Conclusions　MTX injection by hysteroscopic tubal catheterization for unruptured tubal pregnancy is effective, simple, minimally invasive and safe.

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更新日期/Last Update: 2014-07-02