MTX8日方案在异位妊娠保守治疗的疗效分析

Analysis of the effect of the 8-day schedule ethotrexate in treatment of ectopic pregnancy

目的观察甲氨蝶呤(MTX)8日方案对异位妊娠治疗的临床效果及副反应情况。方法对2009年1月～2013年3月我院妇科收治的具有保守治疗指征且要求保守治疗的235例异位妊娠患者,均采用MTX 8日方案治疗。结果 MTX 8日方案保守治疗成功157例(66.81%),改手术治疗78例(33.19%),≥2个疗程治疗成功者63例(46.50%)。副反应发生情况:白细胞减少35例(14.89%),血小板减少13例(5.53%),发生肝毒性16例(6.81%),恶心、呕吐126例(53.62%),口腔溃疡21例(8.94%),仅白细胞减少病例中有2例Ⅲ度副反应,占白细胞减少发生率的5.72%,其余无Ⅲ、Ⅳ度副反应发生。结论 MTX 8日方案在异位妊娠保守治疗成功率高,住院治疗时间较短,毒副反应轻,安全性高,适用于具有保守治疗指征且要求保守治疗的异位妊娠患者。

Objective To observe and analysis the effect and toxicity of the 8-day schedule Methotrexate（MTX） in treating the ectopie pregnancy. Methods 235 cases of ectopic pregnancy from our hospital being fit and request expectant treatment were all treated by the 8-day schedule MTX. Results The cure rate of the 8-day schedule MTX is 66.81% （157/235）, and the rate of operation is 33.19% （78/235）, the rate of ≥ courses of treatment is 46.50% （63/157）. The incidence rates of leukopenia, thrombocytopenia, hepatotoxicity, nausea and vomit and mouth ulcer in the treatment are 14.89% （35/235）, 5.53 % （13/235）, 6, 81% （16/235）, 53.62 % （126） and 8.94 % （21）. The rate of Ⅲ degree ad- verse reaction is 5.72%（2/35） of leukopenia, but there are no Ⅲ and IV degree adverse reaction. Conclusion The 8-day schedule MTX is effective and safe in treatment of ectopic pregnancy. So it is valuable to apply in conservative treatment for the patients.