氨甲喋呤联合米非司酮治疗非破裂型输卵管妊娠的疗效分析

Clinical efficacy of methotrexate combined with mifepristone against unruptured tubal pregnancy

目的:探讨氨甲喋呤联合米非司酮治疗非破裂型输卵管妊娠的临床效果。方法:选取2009年8月～2010年1月我院住院治疗的非破裂型输卵管妊娠86例,随机分为观察组与对照组两组,观察组采用氨甲喋呤联合米非司酮治疗,米非司酮50mg,2次/d,连服3d为1个疗程,总量300mg,同时氨甲喋呤20mg/d静脉推注,连用3d为1个疗程;对照组应用氨甲喋呤20mg/d静滴,连用5d;对比两组患者治疗效果及治疗前后HCG、盆腔包块变化情况。结果:观察组治疗1周后血HCG显著低于对照组(P<0.05),治疗3周后盆腔包块缩小或消失率显著高于对照组(P<0.05)。结论:米非司酮和氨甲喋呤联合治疗输卵管妊娠具有疗程短、疗效确定、不良反应小等优点,值得临床推广。

Objective： To evaluate the clinical efficacy of methotrexate（MTX） combined with mifepristone against unruptured tubal pregnancy.Methods：Eighty six patients with unruptured tubal pregnancy that admitted during August 2009 and January 2010 were randomly divided into trial group and control group.The trial group was given mifepristone,50 mg b.i.d.,3 consecutive days of treatment consisted a treatment course,and total dosage of mifepristone was 300 mg;meanwhile,MTX was also given at the dosage of 20 mg/d i.v.,3 consecutive days of treatment consisted a treatment course.The control group was given MTX at 20 mg per day ivgtt,a consecutive 5 days was a treatment course.Serum HCG level and changes in pelvic mass size were compared between the two groups.Results：After 1 week of treatment,serum HCG level was significant lower than that of the trail group（P0.05）,after 3 weeks of treatment,pelvic mass shrunk rate or disappearing rate was obviously higher than that of the control group（P0.05）.Conclusions：Combined treatment of MTX and mifepristone shows advantages of confirmative therapeutic effects,short treatment course and lower incidence of side effects against tubal pregnancy,thus it＇s worthy of application in large scale.