甲氨蝶呤与米非司酮联合应用方案对异位妊娠的临床效果分析

Clinical Effect of Methotrexate Combined with Mifepristone in the Treatment of Ectopic Pregnancy

目的分析甲氨蝶呤与米非司酮联合应用方案对异位妊娠的临床效果。方法选择妇产科2014年8月～2015年7月收治的86例异位妊娠患者作为观察对象,根据患者入院日期尾数的奇偶分为研究组42例和对照组44例。研究组患者应用甲氨蝶呤按1 mg/kg单次肌注治疗,联合米非司酮25 mg,每天2次;对照组患者则给予0.4 mg/kg的甲氨蝶呤肌注,同时联合25 mg米非司酮治疗。对比临床效果和不良反应反应发生率。结果研究组的治疗有效率稍高于对照组,但是差异结果无统计学意义（P〉0.05）;治疗后两组患者的血-β-h GG值均出现一定程度的下降,第7天的指标差异显著,具有统计学意义（P〈0.05）;对照组患者的不良反应发生率明显高于研究组,差异具有统计学意义（P〈0.05）。结论不同剂量的甲氨蝶呤治疗异位妊娠的结果相似,但是1.0 mg/kg的剂量给药在确保疗效的基础上能够显著降低不良反应的发生率,确保患者用药安全,值得临床推广应用。

Objective To analyze the clinical effect of combined application of methotrexate and mifepristone in treatment of ectopic pregnancy. Methods From August 2014 and 2015 July,86 cases with ectopic pregnancy in Department of Obstetrics and gynecology,Shenyang Weikang Hospital were treated,they were randomly divided into study group（ 42 cases） and the control group（ 44 cases） according to parity with date of admission of the mantissa. Patients in the study group treated with methotrexate 1mg / kg single intramuscular injection,combined with mifepristone 25 mg,2 times a day; control group patients give 0. 4 mg / kg methotrexate intramuscular injection,combined with 25 mg mifepristone treatment. Compare the clinical effect and the incidence of adverse reaction. Results Effective rate of the treatment group is slightly higher than the control group,but differences in the statistical significance（ P〉0. 05）. After treatment of two groups of patients with blood beta-h GG values are decreased in a certain degree,on the 7th day of the indicators are significant differences,with statistical significance（ P〈0. 05）; in the control group,the incidence rate of adverse reaction was significantly higher than that in study group,the difference is statistically significant（ P〈0. 05）. Conclusions Different doses of methotrexate for treatment of ectopic pregnancy have similar clinical effect,but 1. 0 mg / kg dose administered on the basis to ensure the efficacy of can significantly reduce the incidence of adverse reactions,in order to ensure the safety of patients with medication,it is worthy of clinical application.