米非司酮联合氨甲蝶呤治疗输卵管妊娠的疗效分析

Analysis of the Curative Effect of Mifepristone Plus Methotrexate in the Treatment of Tubal Pregnancy

目的探讨米非司酮联合氨甲蝶呤保守治疗异位妊娠的疗效及方法。方法对98例输卵管妊娠的就诊妇女随机分为研究组和对照组各49例,采用口服米非司酮、肌注氨甲蝶呤,观察腹痛、阴道出血、β-HCG,B超了解盆腔包块和药物的副反应。结果研究组米非司酮联合氨甲蝶呤治疗异位妊娠的成功率为81.6%,对照组单用氨甲蝶呤成功率为63.3%,研究组的成功率较对照组明显提高(P<0.05)。研究组在观察治疗中阴道出血时间、腹痛消失时间和β-HCG转阴时间较对照组明显缩短,差异有统计学意义(P<0.05)。米非司酮联合氨甲蝶呤治疗输卵管妊娠比单用氨甲蝶呤治疗效果好,β-HCG下降快,成功率高,副作用小。结论米非司酮联合氨甲蝶呤治疗输卵管妊娠安全、有效、方便、副反应小,值得推广。

Objective To observe the efficacy and method of mifepristone plus methotrexate on conservative treatment of tubal pregnancy. Methods 98 cases of tubal pregnancy were divided into control group and study group randomly. 49 cases of tubal pregnancy were treated with methotrexate intramuscular injection. 49 cases of tubal pregnancy in study group were treated with methotrexate intramuscular injection combined with oral mifepristone.After treatment,the stomachache, the colporrhagia, the serum β-HCG levels,the volume of pelnic mass observed by B-ultrasonic inspection and side reaction of medication were examined. Results The curative rate was 81.6% in study group than 63.3% in control group（P〈0.05）. There were significant difference between treatment group and control group in the time of vaginal hemorrhage, disappearing of abdominal pain and decreasing the level of β-HCG （P〈0.05）. Compared to treatment of tubal pregnancy by methotrexate, the treatment of tubal pregnancy by mifepristone plus methotrexate was more effective,successful,quickly decrease in the serum β-HCG levels and minor side reaction. Conclusion Mifepristone plus methotrexate in the treatment of tubal pregnance is a safe, effective, convenient and minor side reaction method. It is worth to popularize in clinical application.