4例小剂量甲氨蝶呤治疗异位妊娠致严重不良反应分析

Analysis of serious adverse reactions due to four low-dose methotrexate treated in ectopic pregnancy

目的分析应用小剂量甲氨蝶呤治疗异位妊娠致附件包块破裂或腹腔积血的发生机制及预测标准,为临床安全用药提供参考。方法药师监护小剂量甲氨蝶呤治疗异位妊娠致3例附件包块破裂和1例腹腔积血的案例。根据患者临床症状和检查结果,药师及时发现药物不良反应,为医师制定最佳的治疗方案提供意见。结果3例附件包块破裂患者及时行手术治疗后出院,1例腹腔积血患者经保守止血药物治疗成功。结论小剂量甲氨蝶呤治疗异位妊娠也可能发生附件包块破裂或腹腔积血的严重不良反应。医师在治疗过程中应对患者进行监护,根据临床表现和检查结果预测附件包块破裂的可能性,制定相应治疗方案,保证患者的用药安全。

Objective To analyzethemechanismand prediction criteriaof low-dosemethotrexatefor accessory mass rupture or abdominal hemorrhage in ectopic pregnancy,so as to provide a reference for safe clinical drug use.Methods The pharmacist monitored the treatment of low-dose methotrexate in three cases of attachment mass rupture and one case of abdominal hemorrhage.According to the clinical symptoms and examination results,pharmacists find adverse drug reactions in time and provide advice for doctors to develop the best treatment plan.Results Three patients with ruptured attachment mass were discharged after timely surgery,and one patient with abdominal hemorrhage was successfully treated with conservative hemostatic drugs.Conclusion Serious adverse effects of attachment bundle rupture or abdominal hemorrhage may also occur in low-dose methotrexate treatment in ectopic pregnancy.Doctors should monitor the patients during the treatment process,predict the possibility of attachment block rupture according to the clinical manifestations and examination results,and formulate corresponding treatment plans to ensure the safety of drug use of patients.