MTX与米非司酮预防持续性异位妊娠的分析

An Analysis of MTX or Mifepristone Prevention to Persistent Ectopic Pregnancy

目的 探讨用氨甲蝶呤 (MTX)及米非司酮用于预防腹腔镜下保守性手术后持续性异位妊娠 (PEP)的治疗效果。 方法 对 2 0 1例异位妊娠患者行腹腔镜下保守性手术 ,10 9例在残腔内注入MTX 2 0mg ,另 92例术后口服米非司酮 3 0 0mg。 结果 保守性手术中用MTX后PEP发生率为 0 .92 % ,而米非司酮组为 2 .17% ,差异不显著 (P >0 .0 5 )。术后第 1d两组血 β -HCG均有大幅度下降 ,下降率分别为 73 .3± 0 .16%和 5 0 .8± 0 .2 1% ,而两组间比较也有明显差异 ,术后 3、6、12d血 β -HCG下降两组间差异不显著。 结论 用MTX及米非司酮能成功预防腹腔镜下保守性手术后PEP的发生 ,副作用小 ,是腹腔镜保守手术治疗异位妊娠有效的辅助手段。

Objective To analyze the therapeutic effect of methotrexate (MTX) or mifepristone prevention to persistent ectopic pregnancy after conservatively laparoscopic operation. Method Two hundred and one ectopic pregnancy patients were chosen and conservatively operated on, MTX 20mg were poured into fallopian tube lumen in 109 cases , another 92 cases took mifepristone after the operation. Result The incidence of persistent ectopic pregnancy was 0.92% with MTX in conservatively laparoscopic operation, and the incidence with mifepristone was 2.17%, the difference was not statistically significant (P> 0.05). Serum β-HCG in two groups descended by large scope in the first 24 hours after operation, descent rate was 73.3±0.16%and 50.8±0.21%, and the difference has statistical significance between two groups (P<0.05). Serum β-HCG descent in two groups in 3 days, 6 days, 12 days has no statistical significance. Conclusion Methotrexate (MTX) or mifepristone can prevent persistent ectopic pregnancy occurrence after conservatively laparoscopic operation, and the side effect is small, which is an effective subsidiary way to treat persistent ectopic pregnancy.