甲氨蝶呤、米非司酮对异位妊娠保守治疗的研究  

Study on Combined Methoxamine and Mifepriston Conservative Therapy in Ectopic Pregnancy

作　　者：张建鸿[1] 

机构地区：[1]东莞市人民医院,广东东莞523000

出　　处：《实用预防医学》2007年第3期810-811,共2页Practical Preventive Medicine

摘　　要：目的探讨保守治疗异位妊娠的几种方案。方法将107例异位妊娠患者,根据治疗方案不同分为3组,比较各组治疗效果。单纯甲氨蝶呤(MTX)肌内注射治疗36例,为MTX组;单纯米非司酮(RU486)治疗31例,为RU486组;MTX与RU486联用治疗40例,为MTX+RU486。结果甲氨蝶呤(MTX组)33例治愈(91.67%),MTX+米非司酮(RU486)组38例治愈(95.00%),两组疗效比较,差异无显著性(P>0.05)。当血β-HCG>2000U/L时,两组第二次注射MTX病例增多,分别达到28.57%和21.74%。RU486组23例治愈(74.2%),当血β-HCG≤2000U/L时,治愈率为92.31%。结论当血β-HCG≤2000U/L时,3种保守治疗方法对异位妊娠患者均有效;当血β-HCG>2000U/L时,MTX+RU486组疗效最佳,其次是MTX组,而RU486组疗效欠佳。Objective To investigate the different protocols for conservative treatment of ectopic pregnancy. Methods Treatment in 107 women with ectopic pregnancy was retrospectively analyzed. According to the treatment protocols, they were assigned into 3 groups： 36 cases received intramuscular MIX as （MTX group）, 31 cases received oral Mifepriston （RU486 group）, and 40 cases received combined MIX and Mifepriston treatment （MTX ＋ RU486 group）. Resuls Thirtythree patients （91.67 % ） in the MTX group and 38 patients （9.5.0 % ） in the MTX ＋ RU486 group were cured, and the curative rate showed no significant difference between the MIX group and the MIX ＋ RU486 group （ P 〉 0.05 ）. The need of second dose of MTX for curing increased when serum β- HCG level was 〉2,000U/L, which reached 28.57% in the MTX group and 21.74% in the MTX＋ RU486 group. Twenty- three patients （74.2%） in the MTX＋ RU486 group were cured, the curative rate reached 92.31% when the β- HOG levels were ≤2,000U/L. Conclusion The three different treatment protocols are effective for patients with ectopic pregnancy when the β- HCG levels are ≤2,000U/L. When the β- HOG levels are 〉2,000 U/L, the combined treatment of MTX and Mifepriston is the most effective protocol, while mifepriston alone is the least effective one.

关 键 词：异位妊娠 保守治疗 Β-HCG 米非司酮 甲氨蝶呤 

分 类 号：R714.22[医药卫生—妇产科学]