甲氨蝶呤联合米非司酮治疗输卵管妊娠的疗效观察

Efficacy Observation of Methotrexate Combined with Mifepristone in the Treatment of Tubal Pregnancy

目的:观察甲氨蝶呤联合米非司酮治疗输卵管妊娠的疗效和安全性。方法:将112例确诊的输卵管妊娠患者随机分为2组,对照组56例使用甲氨蝶呤0.1mg.kg-1.d-1,肌肉注射,连用5 d;治疗组56例在对照组的基础上,于应用甲氨蝶呤第2天开始加服米非司酮50mg,q12h,连用3d。观察2组的疗效和不良反应。结果:2组患者有效率比较,差异有统计学意义(P<0.05),治疗组显著优于对照组(89.3%vs.78.6%)。2组患者住院时间、血β-人绒毛膜促性腺激素(HCG)改善时间差异均有统计学意义(P<0.05),治疗组均短于对照组。2组患者均出现少数不良反应,治疗组不良反应发生率显著低于对照组(P<0.05)。结论:甲氨蝶呤联合米非司酮治疗输卵管妊娠疗效较好,不良反应少,效果优于单用甲氨蝶呤。

OBJECTIVE： To observe the efficacy and safety of methotrexate combined with mifepristone in the treatment of tub- al pregnancy. METHODS： 102 cases diagnosed as tubal pregnancy were randomly divided into 2 groups, 56 cases in control group were given intramuscular injection of methotrexate 0.1 mg.kg-1 .d-1 for consecutive 5 d; based on the treatment of control group, treatment group were additionally given mifepristone 50 mg orally, ql2h, since the second day of administration, for consecutive 3 d. Therapeutic efficacy and adverse drug reactions of 2 groups were observed. RESULTS： The effective rate of 2 groups had signifi- cant statistical difference （P〈0.05）, treatment group was significantly better than that control group （89.3% vs. 78.6% ）. The hos- pitalization time and the duration of serum β-HCG improvement in 2 groups had statistical significance （P〈0.05）, those of treat- ment group both were shorter than control group. Few adverse reactions were found in 2 groups, the ADR rate in treatment group is obversiously lower than control group. CONCLUSION： Methotrexate combined with mifepristone in the treatment of tubal preg- nancy is effective with few adverse drug reactions, the effect of which is better than methotrexate alone.