非破裂型输卵管异位妊娠患者联合米非司酮、甲氨蝶呤治疗的有效性和安全性

Effectiveness and Safety of Combined Treatment with Mifepristone and Methotrex⁃ate in Patients with Non-ruptured Fallopian Tube Ectopic Pregnancy

目的分析非破裂型输卵管异位妊娠(non-ruptured tubal ectopic pregnancy,NRTEP)患者联合使用米非司酮、甲氨蝶呤的效果。方法从2018年5月—2022年5月盐城市第三人民医院收治的NRTEP患者中随机抽取130例,按随机数表法分为A组(65例,应用甲氨蝶呤治疗)和B组(65例,应用甲氨蝶呤+米非司酮治疗),对比两组治疗效果、不良反应、临床指标、生活质量和再次妊娠情况。结果B组治疗有效率为96.92%高于A组,差异有统计学意义(χ^(2)=5.875,P<0.05),B组不良反应发生率高于A组,但对比差异无统计学意义(P>0.05);B组临床指标(血β-人绒毛膜促性腺激素转阴时间、包块消失时间、阴道流血时间、腹痛时间、住院时间、输卵管通畅率)优于A组,差异有统计学意义(P<0.05);B组再次妊娠情况优于A组,差异有统计学意义(P<0.05);治疗后,B组生活质量量表-36评分高于A组,差异有统计学意义(P<0.05)。结论NRTEP患者联合使用米非司酮、甲氨蝶呤,能快速改善临床症状,有利于患者提高生活质量,改善再次妊娠情况,疗效显著且安全性高。

Objective To analyze the effect of combined use of mifepristone and methotrexate in patients with non-ruptured tubal ectopic pregnancy(NRTEP).Methods A total of 130 NRTEP patients admitted to Yancheng Third People's Hospital from May 2018 to May 2022 were randomly selected and divided into group A(65 cases,treated by methotrexate)and group B(65 cases,treated by methotrexate+mifepristone)according to random number table method.The therapeutic effect,adverse reactions,clinical indicators,quality of life and the condition of re-pregnancy of the two groups were compared.Results Treatment effective rate group B was of 96.92%,which was higher than that of group A,the difference was statistically significant difference(χ^(2)=5.875,P<0.05),the incidence of adverse reaction was higher than group A but there was no statistical significance difference(P>0.05);the clinical indicators(bloodβ-human chorionic gonadotropin negative time,mass disappearance time,vaginal bleeding time,abdominal pain time,hospitalization time,fallopian tube patency rate)in group B were better than those in group A,the differences were statistically significant(P<0.05).The re-pregnancy of group B was better than that of group A,and the difference was statistically significant(P<0.05).After treatment,the quality of life scale-36 score higher than group B,group A was statistically significant difference(P<0.05).Conclusion The combined use of mifepristone and methotrexate in NRTEP patients can quickly improve clinical symptoms,help patients improve their quality of life,and improve re-pregnancy.It has significant efficacy and high safety.