米非司酮联合甲氨蝶呤保守治疗异位妊娠的临床研究

Clinical Research on Mifepristone and Methotrexate in Conservative Treatment of Ectopic Gestation

目的探究米非司酮联合甲氨蝶呤的保守治疗对异位妊娠的疗效。方法选取2014年3月—2015年11月在该院接受治疗的60例异位妊娠患者,按随机数表法分为对照组(n=30)与观察组(n=30),对照组患者单用米非司酮保守治疗,观察组患者采用米非司酮联合甲氨蝶呤治疗,对两组患者的腹痛、治愈率、血β-HCG转阴时间等指标进行比较。结果治疗组患者治疗有效率(86.7%)显著高于对照组患者治疗有效率(67.7%)(P<0.05);14 d后,治疗组腹痛消失或者症状明显减轻比例86.7%高于对照组60.0%,B超示腹部包块缩小比例高于对照组90.0%、66.7%(P<0.05);平均住院时间与血β-HCG转阴时间治疗组患者分别为(9.3±2.1)d、(11.5±3.2)d显著短于对照组患者(14.4±3.3)d、(17.6±4.3)d(P<0.05)。结论米非司酮联合甲氨蝶呤保守治疗异位妊娠,疗效可靠,相比单独用药改善效果显著,不良反应较少,考虑联合用药推广。

Objective To study the curative effect of mifepristone and methotrexate in conservative treatment of ectopic gestation. Methods 60 cases of patients with ectopic gestation treated in our hospital from March 2014 to November 2015 were selected and randomly divided into two groups with 30 cases in each, the control group adopted the ectopic gestation conservative treatment, while the observation group adopted the mifepristone and methotrexate treatment, and the bellyache, cure rate and negative conversion time of blood β-HCG were compared between the two groups. Results The treatment effective rate in the treatment group was obviously higher than that in the control group（86.7% vs 67.7%） （P〈0.05）, after 14d, the bellyache disappearance time or ratio of symptom relieved obviously in the treatment group was higher than that in the control group（86.7% vs 67.7%）（P〈0.05）, and the B ultrasound showed that the decrease ra- tio of abdominal mass was higher than that in the control group （90.0% vs 66.7%）（P〈0.05）, and the average length of stay and negative-conservation time of blood -HCG in the treatment group were obviously shorter than those in the control group [（9.3±2.1 ）d, （ 11.5 ±3.2）d vs （ 14.4±3.3）d, （ 17.6±4.3）d] （P〈0.05）. Conclusion The curative effect of mifepristone and methotrexate in conservative treatment of eetopic gestation is reliable, and the improvement effect of single medication is obvious with fewer adverse reactions, which should be promoted.