甲氨蝶呤单次肌内注射与小剂量分次肌肉注射联合米非司酮保守治疗异位妊娠的疗效及安全性

Efficacy and safety of methotrexate single intramuscular injection and low dose fractionated intramuscular injection combined with mifepristone retention in the treatment of ectopic pregnancy

目的探讨甲氨蝶呤单次肌内注射与小剂量分次肌肉注射联合米非司酮保守治疗异位妊娠疗效及安全性。方法选取我院2015年5月至2016年7月收治的102例异位妊娠者为研究对象,按照甲氨蝶呤给药方式不同将所选患者分为对照组和观察组,各51例。对照组采用多次小剂量甲氨蝶呤肌注联合米非司酮治疗,观察组采用单次甲氨蝶呤肌注联合米非司酮治疗。比较两组临床疗效、治疗后血β-HCG下降率以及不良反应反应总发生率。结果两组治疗总有效率和治疗后第4、7、10 d血β-HCG下降率比较,均无明显差异(P>0.05);观察组不良反应总发生率(9.80%)明显低于对照组(29.41%)(P<0.05)。结论单次肌注甲氨蝶呤联合米非司酮治疗异位妊娠其不良反应少,安全性更高,使用方便,值得临床运用推广。

Objective To investigate the efficacy and safety of methotrexate single intramuscular injection and low dose fractionated intramuscular injection combined with mifepristone in the treatment of ectopic pregnancy.Methods One hundred and two patients with ectopic pregnancy admitted in our hospital from May 2015 to July 2016 were selected and divided into control group and observation group according to the mode of methotrexate administration,with 51 cases in each group.The control group was treated with low dose fractionated intramuscular injection combined with mifepristone.The observation group was treated with single methotrexate intramuscular injection combined with mifepristone.The clinical effect,decrease rate of bloodβ-HCG after treatment and incidence rate of adverse reactions were compared between the two groups.Results The differences of total effective rate of treatment and the decrease rate ofβ-HCG after treatment for 4,7 and 10 days were not statistically significant between the two groups(P>0.05).The total incidence rate of adverse reactions in the observation group(9.80%)was significantly lower than that in the control group(29.41%)(P<0.05).Conclusion Single methotrexate intramuscular injection combined with mifepristone in the treatment of ectopic pregnancy has less adverse reactions and higher safety.It is convenient to use,which is worthy of clinical application and popularization.