甲氨蝶呤囊内注射联合米非司酮治疗瘢痕妊娠的临床研究

Clinical trial of methotrexate sac injection combined mifepristone in the treatment of scar pregnancy mifepristone

目的观察疤痕妊娠患者应用甲氨蝶呤囊内注射联合米非司酮的疗效。方法收集本院2011年10月至2016年10月收治的98例疤痕妊娠患者,按照随机法将其分为2组,每组49例。对照组在囊内局部注射50 mg·m^(-2)甲氨碟呤,试验组在对照组基础上加用米非司酮治疗,口服25 mg,每日1次,连用3 d。观察2组疗效、临床表现缓解时间和药物不良反应(ADR);用全自动生化分析仪测定血人绒毛膜促性腺激素(β-HCG)水平。结果试验组和对照组的成功率分别为91.83%(45例/49例),75.51%(37例/49例),差异有统计学意义(P<0.05)。试验组临床表现缓解时间少于对照组,差异有统计学意义(P<0.05)。治疗后,试验组和对照组血β-HCG分别为(75.76±10.39),(118.77±14.86)mU·mL^(-1),试验组与对照组比较,差异有统计学意义(P<0.05)。对照组和试验组的ADR发生率分别为26.53%(13例/49例),8.16%(4例/49例),试验组明显低于对照组,差异有统计学意义(P<0.05)。结论疤痕妊娠患者用甲氨碟呤囊内注射联合米非司酮治疗的疗效优于单用甲氨碟呤,能够提高临床效果,促进病情恢复;且安全性提高。

Objective To research curative effect and safety of methotrexate sac injection combined mifepristone in the treatment of scar pregnancy mifepristone. Methods Total of 98 patients with scar pregnancy from October 2011 to October 2016,according to lottery method was divided into control group and treatment groups,49 cases in each group.Control group treated by methotrexate sac injection,local injection of 50 mg·m^（-2） methotrexate. Based on the control group,treatment group treated with mifepristone,oral 25 mg,1 times a day,stay for 3 days.Curative effect,alleviate clinical symptoms time,levels of blood human chorionic gonadotropin（ β-HCG） and adverse drugs reaction（ ADR）were observed between two groups. Results Success rates of treatment group and control group respectively were 91. 83%（ 45 cases/49 cases）and 75. 51%（ 37 cases/49 cases）,difference was statistically significant（ P 0. 05）. Clinical performance remission time of treatment group was better than that of control group,difference was statistically significant（ P 0. 05）. The blood β-HCG of treatment group and control group respectively were（ 75. 76 ± 10. 39）,（ 118. 77 ± 14. 86） mU·mL^（-1）,the difference was statistically significant（ P 0. 05）. The incidence rates of ADR in the control group and treatment group were 26. 53%（ 13 cases/49 cases）,8. 16%（ 4 cases/49 cases）,the difference was statistically significant（ P 0. 05）. Conclusion Clinical efficacy of methotrexate sac injection combined with mifepristone in the treatment of scar pregnancy is better than methotrexate sac injection alone,it can improve clinical results,promote disease recovery and had good safety.