MTX介入治疗未破裂型输卵管妊娠的临床分析

Clinical analysis of MTX interventional treatment in unruptured tubal pregnancy

目的探讨B超引导下氨甲喋呤(MTX)局部治疗未破裂型输卵管妊娠的疗效。方法选择早期未破裂型输卵管妊娠68例,分为二组进行治疗。介入治疗组:34例,在B超引导下经穹窿穿刺入妊娠包块内,局部注射MTX50mg;对照组:34例,全身用药,MTX50mg静脉注射。用药1w后两组若血血绒毛膜促性腺激素(β-hCG)下降<15%,可再次用药。比较两组MTX平均用量、住院时间、β-hCG下降速度、治疗成功率、药物副反应。结果介入治疗组MTX平均用量(60.61±20.76)mg,平均住院时间(16.42±3.80)d;对照组MTX平均用量(88.46±23.00)mg,平均住院时间(25.77±5.13)d;两组间比较,差异有统计学意义,P<0.01。两组病例血β-hCG下降速度、治疗成功率及药物毒副反应比较,同样差异有统计学意义,P<0.01。结论对于未破裂型输卵管妊娠,B超引导下MTX局部注射治疗效果优于全身用药。

Objective To discuss the effect of methotrexate（MTX） interventional treatment in unruptured tubal pregnancy under B ultrasound guidance. Methods 68 patients with early unruptured tubal pregnancy were randomly divided into two groups . Methotrexate （MTX） interventional treatment group included 34 cases, MTX （50mg） were injected into the mass of the tubal pregnancy through vault puncture under B ultrasound guidance. In the control group, 34 cases had systematic therapy, and MTX （50mg） were injected through vein pump, One week after treatment ,if Beta-hCG of women in both groups decrease 〈 15% , the treatment would continue. The dose of MTX, period in hospital, the velocity of Beta-hCG decrease, success ratio and side effects of the drug between the two groups were compared. Results Significant differences were found between the two groups when mean MTX dose of interventional treatment were 60.61 ± 20.76 rag, mean in-hospital days were 16.42 ± 3.80, and mean MTX dose of control group were 88.46 ± 23.00 mg , mean in-hospital days were 25.77 ± 5.13, P 〈 0.01. Furthermore, Beta-hCG decrease velocity, success ratio and side effects of the drug also presented the same results. Conclusions Local MTX injection under B ultrasound guidance is more effective than systematic therapy in unruptured tubal pregnancy.