甲氨蝶呤联合米非司酮治疗异位妊娠患者对临床疗效、血清β-HCG及并发症的影响

Effects of methotrexate combined with mifepristone on clinical efficacy,serum-hcg and complications in patients with ectopic pregnancy

目的探讨甲氨蝶呤联合米非司酮治疗异位妊娠的临床疗效及对其血清β-HCG及并发症的影响。方法选取2016年1月至2018年12月高州市人民医院收治的80例异位妊娠患者随机等分为观察组与对照组,对照组予以甲氨蝶呤治疗,观察组予以甲氨蝶呤联合米非司酮治疗,对比两组疗效。结果观察组治愈37例(92.5%)、失败3例(7.5%),对照组治愈31例(77.5%)、失败9例(22.5%);观察组的治愈率高于对照组(P<0.05)。观察组有2例口腔溃疡,1例恶心呕吐,并发症率7.5%;对照组有3例恶心呕吐,3例口腔溃疡,1例肠道异常,并发症率17.5%;观察组的并发症率少于对照组(7.5%比17.5%,P<0.05)。观察组患者的症状消失[(4.27±0.75)d比(7.45±1.39)d]、血β-HCG恢复正常[(12.37±1.67)d比(16.10±2.95)d]、尿β-HCG转阴[(10.49±2.31)d比(10.49±2.31)d]、盆腔包块消失[(10.49±2.31)d比(23.83±2.85)d]、住院时间[(23.65±4.01)d比(29.58±5.39)d]短于对照组(P<0.001)。观察组患者治疗后血β-HCG[(1189.35±52.43)IU/L比(1395.78±56.82)IU/L]及孕酮水平[(4.25±0.92)mg比(6.71±0.95)mg]、包块直径[(1.43±0.35)cm比(2.25±0.39)cm]小于对照组(P<0.05)。结论甲氨蝶呤联合米非司酮治疗可有效改善异位妊娠的临床症状,促进血β-HCG恢复正常,促进盆腔结块消失,临床疗效良好,安全性高,值得推荐。

Objective To investigate the clinical efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy and its effect on serum-hcg and its complications.Methods 80 patients with ectopic pregnancy admitted to our hospital from January 2016 to December 2018 were randomly divided into the observation group and the control group.The control group was treated with methotrexate,and the observation group was treated with methotrexate combined with mifepristone,and the efficacy of the two groups was compared.Results 37 cases(92.5%)were cured and 3 cases(7.5%)failed in the observation group,31 cases(77.5%)were cured and 9 cases(22.5%)failed in the control group.The cure rate in the observation group was higher than that in the control group(P<0.05).In the observation group,there were 2 cases of oral ulcer,1 case of nausea and vomiting,and the complication rate was 7.5%.In the control group,there were 3 cases of nausea and vomiting,3 cases of oral ulcer and1 case of intestinal abnormality,with a complication rate of 17.5%.The complication rate in the observation group was lower than that in the control group(P<0.05).Symptoms disappeared,blood-hcg returned to normal,urinehcg turned negative,pelvic mass disappeared,and the length of hospital stay in the observation group was shorter than that in the control group(P<0.05).Conclusion Combination of methotrexate and mifepristone can effectively improve the clinical symptoms of ectopic pregnancy,promote the return of blood-hcg to normal,and promote the disappearance of pelvic lumps.It has good clinical efficacy and high safety,and is recommended.