异位妊娠不同保守治疗方案的疗效对比

Efficacy comparison of different conservative treatment schemes for ectopic pregnancy

目的探讨不同保守治疗方案治疗异位妊娠的疗效及不良反应。方法回顾性分析2014年1月至2016年10月于广元市妇幼保健院就诊且采取药物保守治疗的249例异位妊娠患者的病例资料。根据治疗方案将患者分为5组:米非司酮组、甲氨蝶呤组、宫外孕I号方组、宫外孕I号方+甲氨蝶呤组和宫外孕I号方+米非司酮组。分析不同药物治疗方案的疗效和不良反应。结果 5组的有效率分别为66.7%、74.5%、80.6%、87.5%和83.7%,各组的人绒毛膜促性腺激素(human chorionic gonadotropin,h CG)转阴中位时间为(18.7±6.9)d、(14.2±5.2)d、(13.9±5.4)d、(10.8±4.9)d和(12.1±5.3)d,各组的不良反应发生率为15.6%、23.5%、5.6%、37.7%和28.6%。在有效率、h CG转阴中位时间和不良反应方面,5组间差异均有统计学意义(P<0.05)。结论单独宫外孕I号方具有较好的治疗效果,血h CG转阴时间相对较短,不良反应最小,是异位妊娠药物保守治疗方案中较好的选择。

Objective To explore the efficacy and side effects of different conservative treatment regimens for ectopic pregnancy. Methods Retrospective analysis of the efficacy and side effects of different conservative treatment regimens for 249 ectopic pregnancy treated in Guangyuan Maternal and Child Health Care Hospital from January 2014 to October 2016. The patients were divided into five groups according to the treatment regimens ： mifepristone group, methotrexate group, ectopie pregnancy prescription I group, ectopie pregnancy prescription I ＋ methotrexate group and eetopie pregnancy prescription I ＋ mifepristone group. Result~ The effective rates were 66. 7%, 74. 5%, 80. 6%, 87.5% and 83.7% ;The median negative time of human chorionic gonadotropin（hCG） were （ 18. 7 ~ 6.9） d, （ 14. 2 ~ 5.2） d, （ 13.9 ＋ 5.4） d, （ 10. 8 ~ 4. 9 ） d and （ 12. 1 ＋ 5.3 ） d; The incidence of adverse reactions in each group was 15.6% , 23.5% , 5.6% , 37. 7% and 28.6%. The differences between the five groups in efficiency, median negative time and adverse reactions were statistically significant （P 〈 0. 05 ）. Conclusion Eetopie pregnancy prescription I has good therapeutic effect, with relatively short blood hCG negative time and minimal adverse reaction.