甲氨蝶呤联合米非司酮终止瘢痕妊娠的安全性探讨

Discussion on safety of methotrexate combined with mifepristone to terminate the scar pregnancy

目的探讨甲氨蝶呤联合米非司酮终止瘢痕妊娠的安全性。方法选择本院和周边医院2011年1月~2013年1月收治的100例子宫切口瘢痕妊娠患者为试验对象,随机分为观察组与对照组,每组各50例,对照组口服米非司酮,观察组在对照组的基础上给予甲氨蝶呤50 mg(在超声引导下经阴道注入)。评定两组治疗6个月的疗效,记录其不良反应。结果两组的治愈率、失败率、包块消失时间、血β-HCG转阴时间及白细胞降低、肝酶升高、口腔炎、消化道炎症、发热等不良反应比较,差异均有统计学意义(P<0.05)。结论米非司酮联合甲氨蝶呤治疗子宫切口瘢痕妊娠,效果显著,不良反应发生率低,其可作为一种较为理想的治疗方法在临床推广使用。

Objective To explore the safety of methotrexate combined with mifepristone to terminate the scar pregnancy. Methods 100 patients with uterine incision scar pregnancy were selected as subjects in our and surrounding hospital from January 2011 to January 2013 and they were randomly divided into the observation group and the control group and there were 50 cases in each group,patients in the control group were given oral mifepristone,while patients in the observation group were given 50 mg methotrexate （it as injected with ultrasound guided transvaginal） on the ba- sis of the control group,the curative effect of two groups after 6 months treatment were assessed,its adverse reactions were recorded. Results The cure rate and failure rate,mass extinction time,blood 13-HCG darkening time and adverse reactions such as leucocyte decreased,liver enzyme increased,stomatitis,gastrointestinal inflammation,fever were com- pared and there was a statistical difference between the two groups （P〈0.05）. Conclusion Mifepristone combined methotrexate has obvious effect in the treatment of uterine incision scar pregnancy,and it has low incidence rate of adverse reactions.It can be used as an ideal treatment method and it is used widely in clinic.