氨甲喋呤联合米非司酮治疗异位妊娠疗效观察

COMBINATION OF METHOTREXATE WITH MIFEPRISTON IN TREATMENT OF ECTOPIC PREGNANCY

目的 :探讨氨甲喋呤 (MTX)与米非司酮 (RU486 )联合治疗异位妊娠的疗效。方法 :A组用 MTX每次 5 0 m g/ m2 ,每天 1次 ,治疗 1d,B组用 MTX5 0 mg/ m2 ,每天 1次 ,治疗 1d,RU486 ,15 0 m g/ d,连用 2 d。每周测定血、尿 HCG判断治疗效果。结果 :A组治疗成功率为 78.6 % ,B组成功率为 83.3% (P >0 .0 5 ) ;当附件区包块在 3～ 6 cm、HCG>2 0 0 0 IU/ L,B组治疗成功率高于 A组 (P <0 .0 5 ) ;B组尿 HCG转阴时间较 A组短 (P <0 .0 5 )。结论 :MTX联合 RU486治疗异位妊娠 ,HCG下降快 ,住院时间短 ,在附件区包块大且 HCG水平高的病例中治愈率高于单独使用 MTX。

Objective: The effect of methotrexate combined with mifepriston to treat early ectopic pregnancy were studied. Methods: Group A with 28 cases were treated by single-dose intremuscle methotrexate 50 mg/m+2.Group B with 36 cases were treated by the same dose of methotrexate and mifepriston 150 mg/d for two days.The serum β-HCG and urine HCG were monitored every week.Results:78.6% in Group A and 83.3% in Group B were successfully treated.If patient had uterine adnexa mass diameter in 3~6 cm and HCG>2 000 IU/L, successful rate in Group B was higher than that in Group A (P<0.05).Urine HCG became negative and was faster in Group B.Conculusion: Methotrexate combined with mifepriston treat early ectopic pregnancy effectively.