三种方法保守治疗异位妊娠疗效观察

The clinical observation of three conservative therapy in ectopic pregnancy

目的:探讨米非司酮(R u486)、甲氨蝶呤(M TX)及两者联合治疗异位妊娠的临床疗效。方法:将68例早期诊断为异位妊娠且符合保守治疗条件的病例随机分为3组:A组28例,甲氨蝶呤50 m g单次肌肉注射;B组22例,米非司酮50 m g,口服,每日2次,用3 d;C组18例,米非司酮50 m g,口服,每日2次,用2 d,然后肌肉注射甲氨蝶呤40m g。结果:A组治愈19例,治愈率为68%;B组治愈16例,治愈率为72%;C组治愈15例,治愈率83%。A、B两组比较差异无显著性(P>0.05);C组疗效优于A、B组(P<0.05);血-βHCG转阴时间A、B、C组分别为(21.4±8.3)d、(20.6±7.8)d、(15.2±6.8)d,A、B两组比较差异无显著性(P>0.05);C组短于A、B组(P<0.05);三组均无肝肾功能损害病例。结论:采用R u486及M TX联合用药治疗异位妊娠疗程短,疗效高,优于单一用药。

Objective：To probe the clinical therapeutic effect of mifepristone（Ru486）,Methotrexate（MTX）and therapeutic alliance in ectopie pregnancy. Methods：Sixty-eight early ectopic pregnancy cases approving for conservative therapy were in random divided into three groups：group A 28 cases：MTX 50 mg,single intramuscular injection （im） ;group B 22 cases ：Ru486 50 mg was used for oral twice in a day ,for 3 days ,group C 18 cases ：Ru486 50 mg was used for oral twice in a day,for 2 days ,then MTX 40 mg,im. Rusults ：The curing cases were respectively 19,16 and 15 cases in group A,B and C. The cure rate were 68%,72% and 83%. There was no difference between group A and B （P〉0. 05）. The clinical effect of group C was more better than group A and B（P〈0. 05）. The darkening time of β- HCG in blood in three groups were（21.4±8.3） d, （20. 6±7.8） d and （15. 2±6.8） d. There was no significant difference between group A and B（P〉0.05）, The time of group C was shorter than group A and B（P〈0. 05）. There were no damage of liver and renal function in three groups. Conelution ： The therapeutic alliance of Ru486 and MTX in ectopic pregnancy has short course of treatment and hypsicurative effect. It is better than single medication.