刍议联合甲氨蝶呤与小剂量米非司酮应用在宫外孕治疗的临床意义

Discussion on the Clinical Significance of Combination of Methotrexate and Mifepristone in the Treatment of Ectopic Pregnancy

目的将甲氨蝶呤(MTX)与小剂量米非司酮联合作用在治疗宫外孕女性患者中的临床价值与疗效。方法在2016年9月-2019年2月间方便选取该院宫外孕女性患者200例,并以随机数字表法分为两组(100例/组),分别予以仅甲氨蝶呤治疗(对照组)和联合小剂量米非司酮治疗(观察组),并对两组结果对照比较。结果观察组住院时间(13±1)d、包块消失时间(11±2)h、血-HCG恢复正常时间(21.2±3.7)h均短于对照组(20±2)d、(19±1)h、(27.8±5.6)h,阴道出血情况(16.2±1.1)mL少于对照组(16.9±1.5) mL,差异有统计学意义(t=31.305、35.777、9.833、3.763,P<0.05);观察组有效率(100.00%)高于对照组(95.00%),差异有统计学意义(χ~2=5.128,P=0.024<0.05);两组不良反应发生率差异无统计学意义(χ~2=0.205,P=0.651>0.05),但观察组不良反应发生情况(2.00%)少于对照组(3.00%)。结论采用"甲氨蝶呤+小剂量米非司酮"的联合治疗方案作用于宫外孕女性患者中效果显著。

Objective To evaluate the clinical value and efficacy of combination of methotrexate(MTX) and mifepristone in the treatment of female ectopic pregnancy. Methods 200 female patients with ectopic pregnancy were selected from September 2016 to February 2019 in the departments, and were convenient divided into two groups(100 cases/group) by random number table method. The patients were treated with methotrexate alone(control group) and mifepristone combined with low dose(observation group), and the results of the two groups were compared. Results The length of stay in the observation group(13±1) d, the time of disappearance of the tumor(11±2) h, and the time of return to normal of blood-HCG(21.2±3.7)h were shorter than that of the control group(20±2)d,(19±1) h,(27.8±5.6) h, and the condition of vaginal bleeding(16.2±1.1) mL was lower than that of the control group(16.9±1.5 mL), with statistically significant differences(t=31.305,35.777, 9.833, 3.763, P<0.05). The effective rate of the observation group(100.00%) was higher than that of the control group(95.00 %), and the difference was statistically significant(χ~2=5.128, P=0.024<0.05). The incidence of adverse reactions in the two groups was not statistically significant(χ~2=0.205, P=0.651>0.05), but the incidence of adverse reactions in the observation group(2.00%) was less than that in the control group(3.00%). Conclusion The combination therapy of methotrexate + mifepristone has a significant effect on women with ectopic pregnancy.