【摘要】 目的比较持续性异位妊娠(persistentectopicpregnancy,PEP)患者腹腔镜手术与药物保守治疗的临床效果。方法52例PEP患者依病情、患者意愿分为药物组(n=24)和腹腔镜组(n=28),分别采用药物(米非司酮、中药、甲氨蝶呤)治疗和腹腔镜手术治疗,比较两组患者保留输卵管率、住院日、住院费用、血β-HCG下降至正常的时间和治疗后腹痛症状发生率。结果保留输卵管率,腹腔镜组与药物组无统计学意义(P>0.05)。腹腔镜组和药物组住院时间、住院费用及血清β-HCG下降至正常时间,腹腔镜组明显短于药物组(P<0.01),腹腔镜组术后无腹痛主诉,药物组6例患者因腹痛重,B超提示附件包块增大,盆腔积液增多行手术补救治疗。结论PEP患者腹腔镜保守性手术可保留患侧输卵管;腹腔镜安全性好,平均住院费用并不增加;药物治疗关键在于正确掌握保守治疗指征,药物治疗失败应及时腹腔镜手术。更多还原

【Abstract】 [Objective] To evaluate the clinical outcome of laparoscopic controlled with conservative medical treatment in the treatment of persistent ectopic pregnancy. [Methods] 52 PEPs were divided into the medicine group (n =24) and the laparoscopic group (n =28) in accordance with the condition and patients’ will, adopt medicine treatment (mifepristone, traditional Chinese medicine, MTX) and laparoscopic separately, compared respectively two groups with oviduct-sparing rate, days and cost of hospitalization, time of blood β-HCG drop to normal, abdominal pain. [Results] The difference in rate of oviduct-sparing rate and cost of hospitalization between two groups was nonsignificant (P >0.05); days of hospitalization, time of blood β-HCG drop to normal of the medicine group is respectively, compared with the laparoscopic group[respectively] the difference was significant (P <0.01). There is no patients suffering from abdominal pain in the laparoscopic group, six patients suffering from serious abdominal pain in the medicine group, B ultrasonic suggest enclosure wrap and pelvic cavity fluidify increased and the remedied laparoscopic was done. [Conclusions] Laparoscopic in the treatment of persistent ectopic pregnancy is effective, safe and well tolerated. If drug treatment is abortive, the remedied operation is imperative and essential.更多还原