氨甲喋呤局部注射配合RU_(486)口服治疗早期异位妊娠疗效观察

Injecting methotrexate locally combined with taking mifepristone orally in treatment of the early ectopic pregnancy

目的 :探讨局部注射氨甲喋呤 (MTX)配合口服米非司酮 (RU4 86 )在早期宫外孕保守治疗中的疗效。方法 :对早期异位妊娠患者采用阴超介入性穿刺局部注射 MTX 5 0 mg/ m2 。选择 4 0例穿刺成功并符合入选条件的患者随机分为两组 :A组单用 MTX,B组在使用 MTX同时口服 RU4 86 。结果 :4 0例全部治疗成功 ,B组在加速 HCG下降、缩短 HCG转阴时间及平均住院时间方面明显优于 A组 (P <0 .0 5 ) ,且不增加毒副反应。结论 :MTX局部给药配合 RU4 86 口服治疗早期异位妊娠确能提高疗效、缩短疗程 ,并可能使疗程中输卵管破裂的危险减小。对 HCG下降过慢者追加 MTX化疗可预防和治疗持续异位妊娠。

Objective:To improve the efficacy in conservative theropy of the early ectopic pregnancy with methotrexate(MTX) local injection Method:40 caces meeting the requirements were divided into two groups group A received MTX 50mg/m 2 injection through vagina by the ultrasound direction,and took mifepristone 25mg orally every 12 hours for three days group B only took MTX injection through vagina Results:40 caces were cured successfully the effect of group A was superior to that of group B in accelerating the decline of serum β HCG level,shortening the time of serum β HCG droped to normal and the average days in hospital And side effects were not increased Conclusion:The treatment of early ectopic pregnancy in combination with injecting MTX locally and taking mifepristone orally can improve the curative effect and shorten the course of treatment without more side effects,and be probable to decrease the risk of the tubal rupture To those whose β HCG decreased too slowly,sing dose intramuscular MTX can prevent and cure their persistent ectopic pregnancy