低剂量米非司酮辅助甲氨蝶呤治疗未破裂异位妊娠的效果及可行性研究

The Efficacy and Feasibility of Low-dose Mifepristone Assisted Methotrexate in the Treatment of Unruptured Ectopic Pregnancy

目的研究低剂量米非司酮辅助甲氨蝶呤治疗未破裂异位妊娠的效果及可行性。方法选取我院2021年2月到2023年2月期间接诊的90例未破裂异位妊娠患者作为研究对象。按照随机数表法分为研究组与对照组各45例。对照组给予甲氨蝶呤治疗,研究组给予低剂量米非司酮辅助甲氨蝶呤治疗。两组患者均连续治疗7d,记录并比较两组患者的治疗效果、治疗前后包块直径、血β-人绒毛膜促性腺激素(β-HCG)值、临床症状改善时间(盆腔包块减小时间、腹痛消失时间、β-HCG水平降低时间)及药物不良反应发生情况。结果研究组患者的总有效率为95.56%,明显高于对照组患者的82.22%(P<0.05);两组患者的包块直径、血β-HCG值在治疗前相比,差异无统计学意义(P>0.05),两组患者治疗后的包块直径、血β-HCG值较治疗前均明显降低,且研究组明显低于对照组(P<0.05);研究组患者的盆腔包块减小时间、腹痛消失时间、β-HCG水平降低时间均明显低于对照组,差异有统计学意义(P<0.05);药物不良反应方面,研究组(15.56%)稍高于对照组(8.89%),但无明显差异(P>0.05)。结论低剂量米非司酮辅助甲氨蝶呤治疗未破裂异位妊娠效果显著,可有效缩短患者临床症状改善时间,有利于降低血β-HCG水平,且安全性高,具有临床应用价值,值得推广。

Objective To investigate the efficacy and feasibility of low dose mifepristone assisted methotrexate in the treatment of unruptured ectopic pregnancy.Methods 90 patients with unruptured ectopic pregnancy who were treated in our hospital from February 2021 to February 2023 were selected as the research subjects.According to the random number table method,they were divided into a study group and a control group with 45 cases each.The control group was treated with methotrexate,while the study group was treated with low-dose mifepristone as an adjunct to methotrexate.Both groups of patients were treated continuously for 7 days,and the therapeutic effects of the two groups of patients were recorded and compared Diameter and blood of the mass before and after treatmentβ-Human chorionic gonadotropin(β-HCG)value,clinical symptom improvement time(pelvic mass reduction time,abdominal pain disappearance timeβ-HCG level reduction time)and occurrence of adverse drug reactions.Results The total effective rate of patients in the study group was 95.56%,significantly higher than 82.22%in the control group(P<0.05);there was no significant difference in mass diameter and bloodβ-HCG between 2 groups before treatment(P>0.05).After treatment,the mass diameter and bloodβ-HCG value of 2 groups were significantly decreased compared with before treatment,and the study group was significantly lower than the control group(P<0.05);the reduction time of pelvic mass,disappearance time of abdominal pain and reduction time ofβ-HCG level in study group were significantly lower than those in control group,and the difference was statistically significant(P<0.05);in terms of adverse drug reactions,the study group(15.56%)was slightly higher than the control group(8.89%),but there was no significant difference(P>0.05).Conclusion Low dose mifepristone assisted methotrexate in the treatment of unbroken ectopic pregnancy has significant effect,which can effectively shorten the improvement time of patients'clinical symptoms,and is conducive to reducing bloodβ-HCG level,and has high safety,clinical application value,worthy of promotion.