摘要目的 观察黄体剥除并用甲氨喋呤预防持续性异位妊娠(PEP)的疗效.方法 将162例有生育要求的异位妊娠患者随机分组,观察组82例,对照组80例.观察组及对照组均腹腔镜下行胚胎清除后局部注射甲氨喋呤25 mg,观察组术中同时行黄体剥除,对照组未行黄体剥除.两组患者均于术前及术后1d、3 d、7 d检测血β-HCG值,观察其疗效.结果 162例异位妊娠中10例发生PEP,其中观察组1例,对照组9例,观察组与对照组的PEP发生率比较差异有显著性(P＜0.05),两组术后24 h血β-HCG较术前的明显下降(P＜0.01),但两组间差异无显著性(P＞0.05),术后3 d、7 d血β-HCG两组间比较差异有显著性(P＜0.01).结论 黄体剥除并用甲氨喋呤更有效预防持续性异位妊娠,方法简便,值得临床进一步推广.

abstractsObjective To study eucleation of corpus luteum and methotrexate to prevent persistent ectopic pregnancy. Methods 162 patients with ectopic pregnancy were randomly divided into two groups .82 cases were in treatment group: MTX was injected into the affected side fallopian tube lumen after laparoscopic salpingostomy and eucleation of corpus luteum was performed.80 cases were in control group:MTX was injected into the same way and eucleation of corpus luteum wasn't performed. Serum HCG was tested for 4 times before the operation one day , three days and the 7 days after operation respectively.Results There were 10 patients of PEP in this study. One patient in treatment group. 9 patients in control group .The difference was significant between treatment group and control group(P＜0.05) .Serum HCG in the two groups decended significantly in the first 24 hours after operation(P＜0.0l).There was significant difference between the two groups (P＞0.05).As for the descending of HCG in day 3 and 7, that of HCG was lower than control group ( P＜ 0.01 ). Conelusion This is an effective and safer method to prevent persistent ectopic pregnancy after eucleation of corpus luteum and methotrexate.