甲氨蝶呤联合米非司酮治疗异位妊娠疗效分析

Effect observation of methotrexate combined with mifepristone in the conservative treatment of ectopic pregnancy

目的观察甲氨蝶呤联合米非司酮保守治疗异位妊娠的疗效。方法 71例患者随机分为治疗组36例和对照组35例。2组均给予肌内注射甲氨蝶呤治疗,治疗组在此基础上加用米非司酮口服治疗。观察2组治疗后血人绒毛膜促性腺激素(β-HCG)下降至正常时间及包块消失时间、临床疗效及不良反应发生情况。结果治疗组血β-HCG下降至正常时间及包块消失时间均低于对照组,差异有统计学意义(P<0.05)。治疗组有效率为80.6%高于对照组的57.1%,差异有统计学意义(P<0.05)。治疗组有7例患者,对照组有15例患者治疗失败,中转手术治疗。2组患者的不良反应较轻微,症状均可耐受,不影响继续治疗,治疗组不良反应发生率为19.4%,对照组为14.3%,2组比较差异无统计学意义(P>0.05)。结论甲氨蝶呤联合米非司酮治疗异位妊娠效果较好,可作为一种安全有效的保守治疗异位妊娠的方法,值得临床推广应用。

Objective To observe the effect of treating ectopic pregnancy with methotrexate combined with mifepristone conservative.Methods 71 cases were randomly divided into treatment group of 36 and control group of 35.Both of 2 groups were treated with methotrexate intramuscular injection,and the treatment group based on this was given additional mifepristone.Observed the time of reduction of β-human chorionic gonadotropin（β-HCG） to normal and the vanish of enclosed mass,the clinical efficacy and adverse reaction after treatment.Results The time of reduction of β-HCG to normal and the vanish of enclose mass of the treatment group were respectively shorter than those of the control group,and the differences were statistically significant（P0.05）.The effective rate of the treatment group was 80.6% higher than 57.1% of the control group,and the difference was statistically significant（P0.05）.The number of patients with treatment failure was 7 in treatment group,and which was 15 in control group, all of the patients were transfered to operation.The adverse reaction of 2 groups was slight, without prejudice to continuing treatment.Conclusion The effect of treating ectopic pregnancy with methotrexate combined with mifepristone shows successful results,which can be used as a safe and effective method for conservative treatment of ectopic pregnancy ,so it is worth clinical popularizing and application.