米非司酮与甲氨蝶呤联合保守治疗异位妊娠的临床观察

Clinical Observation of Combined Conservative Treatment of Mifepristone and Methotrexate on Ectopic Pregnancy

目的:探讨米非司酮与甲氨蝶呤联合治疗异位妊娠的临床疗效。方法:180例异位妊娠患者随机分为米非司酮组(60例)、甲氨蝶呤组(60例)和米非司酮联合甲氨蝶呤组(60例),比较3组疗效。结果:联合治疗组治愈率明显高于甲氨蝶呤组、米非司酮组(P<0.05);治疗后联合治疗组各项临床指标(包块缩小、尿HCG转阴时间、血β-HCG 2周下降、症状消失时间、阴道排出蜕膜管形)改善率均明显高于甲氨蝶呤组、米非司酮组(P<0.05);联合治疗组血β-HCG恢复正常时间明显少于甲氨蝶呤组、米非司酮组(P<0.01);3组治疗后不良反应发生率均较低。结论:米非司酮与甲氨蝶呤联合治疗异位妊娠安全、有效,值得临床推广应用。

Objective： To explore the clinical effects of combined treatment of mifepristone and metlaotrexate on ectopic pregnancy. Methods： Classify the 180 patients with ectopic pregnancy into mifepristone group （60 cases）, methotrexate group （60 cases） and mifepristone ＆ methotrexate group （60 cases） at random; compare the treatment effects on these three groups. Results： The recovery rate of the combine treatment group is obviously higher than mifepristone group and methotrexate group （ P 〈 0. 05） ; After treatment, the improvement rates of all clinical indicators of the combined treatment group （ shrinking of enclosed masses, time of urinary HCG turning negative, reducing of serum 13 - HCG in two weeks, time of symptoms to disappear, decidual cast emitted by vagina） are higher than those of mifepristone group and methotrexate group （ P 〈 0.05 ） ; The recovery time of serum β - HCG in the combined treatment group is obviously shorter than mifepristone group and methotrexate group （ P 〈 0.01 ） . After the treatment of the three groups, the occurrence rates of adverse effects are all low. Conclusions： The combined treatment of mifepristone and methotrexate on ectopic pregnancy is safe and effective, which is worth pro- moting and widely applying in clinical treatment.