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随机试验系统性甲索特雷克萨特与腹腔镜salpingostomy在输卵管怀孕

P J Hajenius¹, S Engelsbel, B W Mol

¹Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, Netherlands. p.hajenius@amc.uva.nl

Lancet (London, England)

|September 23, 1997

概括

系统性甲状腺和腹腔镜salpingostomy是管卵妊娠的有效治疗方法,管卵保存和通透率相似. 需要进一步的研究来确定哪种方法提供更好的长期生育结果.

科学领域:

生殖医学是一种生殖医学.
微创手术是最少的侵入性手术.
药物治疗妊娠并发症的药物治疗.

背景情况:

输卵管妊娠管理的目的是保持生育能力.
laparoscopic salpingostomy 和医疗治疗是节省生育的选择.
将系统性甲状腺素与腹腔镜salpingostomy进行比较对于治疗选择至关重要.

研究的目的:

为了比较系统性甲状腺和腹腔镜salpingostomy对于输卵管怀孕的疗效.
为了评估治疗成功,输卵管的保存和同侧输卵管通透度.
为了评估血液动力学稳定的患者和未断裂的输卵管怀孕的结果.

主要方法:

随机试验比较系统性甲状腺素 (肌内和口服叶酸) 与腹腔镜口术.
纳入标准:血液动力学稳定,腹腔镜证实未破裂的输卵管怀孕.
结果指标:治疗成功 (hCG消除),输卵管保存,同侧输卵管通透性 (hysterosalpingography).

主要成果:

甲索特酸的治疗成功率为82%,而单一疗程的口术成功率为72%.
输卵管的保存率相似:甲托雷克萨特的90%与Salpingostomy的92%相比.
同侧管道通透率也相似:55%的美托特雷克萨特与Salpingostomy的59%.

结论:

系统性甲状腺和腹腔镜salpingostomy都在治疗大多数未破裂的输卵管怀孕病例中取得了成功.
两种治疗方法之间的同侧管道通透率没有显著差异.
长期的生育结果需要进一步调查,以确定最佳的治疗策略.

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