甲氨蝶呤、米非司酮联合腹腔镜保守性手术治疗输卵管妊娠的疗效观察

Efficacy of methotrexate, mifepristone combined with laparoscopic conservative surgery in treatment of tubal pregnancy

目的:探讨甲氨蝶呤联合米非司酮在异位妊娠腹腔镜手术治疗中的协同作用。方法:2009年1月～2010年1月入住本院的80例输卵管妊娠患者行腹腔镜保守性手术后,随机均分成对照组和实验组,对照组术后肌内注射甲氨蝶呤,实验组在对照组的基础上加用米非司酮。观察两组患者血清β-HCG的下降情况和药物的副作用。结果:实验组术后2周血清β-HCG值明显低于对照组(P<0.05);对照组持续性异位妊娠的发生率为10.0%,实验组发生率为2.5%,两组差异有统计学意义(P<0.05);实验组药物副作用发生率为12.5%,对照组的发生率为10.0%,两组差异无统计学意义(P>0.05)。结论:腹腔镜保守性手术可能会发生持续性异位妊娠,术后需适当辅以杀胚治疗,甲氨蝶呤联合米非司酮比传统的甲氨蝶呤单用疗效更好,而且无明显的副作用。

Objective： To study the effects of mifepristone combined with methotrexate in treatment of ectopic pregnancy laparoscopic surgery synergy. Methods： During January 2009 to January 2010,80 cases of tubal pregnancy by laparoscopic conservative surgery were randomly divided into control group and experimental group.The control group intramuscular methotrexate, the experimental group plused mifepristone on the control group basis. Serum β-HCG condition and drug side effects were observed. Results： The serum β-HCG after two weeks was significantly lower than that of the control group （P0.05）. The incidence of persistent ectopic pregnancy rate was 10.0% in control group, 2.5% in the experimental group, the difference was statistically significant（P0.05）; The experimental group was 12.5% of drug side effects and the control group rate was 10.0%, no significant difference between the two groups （P0.05）. Conclusion： Laparoscopic conservative surgery may occur persistent ectopic pregnancy,after surgery to kill embryos is needed. Methotrexate combined with mifepristone is better than methotrexate alone, and has no obvious side effects.