甲氨蝶呤联合米非司酮治疗异位妊娠临床观察  

作　　者：蔺昕燕[1] 王长智[1] 

机构地区：[1]大连医科大学附属二院妇产科,116027

出　　处：《当代医学》2009年第7期32-33,共2页Contemporary Medicine

摘　　要：目的探讨甲氨蝶呤联合米非司酮治疗异位妊娠的疗效。方法将2003年2月～2007年12月在大连医科大学附属二院确诊为输卵管妊娠应用甲氨蝶呤联合米非司酮治疗的295例患者随机分为6组。A组:51例,应用阴道超声引导下异位妊娠囊穿刺注射甲氨蝶呤杀胚术并口服米非司酮;A0组:51例,单纯应用阴道超声引导下异位妊娠囊穿刺注射甲氨蝶呤杀胚术;B组:46例,肌肉注射甲氨蝶呤0.4mg/kg(患者甲氨蝶呤用量20～25mg),每日1次,共5日,并口服米非司酮;B0组:49例,肌肉注射甲氨蝶呤0.4mg/kg(患者甲氨蝶呤用量20～25mg),每日1次,共5日;C组47例,患者肌肉注射甲氨蝶呤1mg/kg,一次性,及米非司酮口服;C0组:51例,患者肌肉注射甲氨蝶呤1mg/kg。结果(1)六组治疗成功率比较:A组成功率为100.00%,A0组成功率为92.16%,差异有统计学意义(P<0.05);B组成功率为93.48%,B0组成功率为75.51%,差异有统计学意义(P<0.05);C组成功率为91.49%,C0组成功率为74.51%,差异有统计学意义(P<0.05)。(2)六组血β-HCG降至正常的平均天数比较:A组为(14.33±2.86)天,A0组为(24.37±4.15)天,差异有统计学意义(P<0.05);B组为(23.11±4.43)天,B0组为(32.67±3.10)天,差异有统计学意义(P<0.05);C组为(25.74±4.57)天,C0组为(34.71±2.93)天,差异有统计学意义(P<0.05)。结论应用甲氨蝶呤联合非司酮治疗异位妊娠安全、有效、经济。Objective： To investigate the effect of methotrexate and mifepristone for the medical treatment of ectopic pregnancy. Methods： 295 pations with ectopic pregnancy were divided into 6 groups. 51 patients in the A group, were treated by methotrexate which guided by transvaginal ultrasound, and took mifepristone at the same time ： 51 patients in the A0 group, were treated by methotrexate which guided by transvaginal ultrasound ; 46 patients in the B group, were treated by methotrexate, 0.4mg/kg, intramuscular, qd, for 5days, and took mifepristone at the same time; 49 patients in the Bo group, were treated by methotrexate, 0.4mg/kg, intramuscular, qd, for 5days; 47 patients in the C group, were treated by methotrexate, 1mg/kg, intramuscular, one time, and took mifepristone at the same time; 51 patients in the Co group, were treated by methotrexate , 1mg/kg, intramuscular. Results： （1） The treatment was more successful in the group A than in the group A0, which was considered statistically significant （p〈0.05）. The treatment was more successful in the group B than in the group B0, which was considered statistically significant （p〈0.05） . The treatment was more successful in the group C than in the group Co, which was considered statistically significant （p〈0.05） ; （2） The mean time to resolution of beta-hCG was 14.33±2.86 days in the A group, and was 24.37±4.15 days in the Ao group, which was considered statistically significant （p〈0.05）; The mean time to resolution of beta-hCG was 23.11±4.43 days in the B group, and was 32.67±3.10 days in the B0 group, which was considered statistically significant （p〈0.05）; The mean time to resolution of beta-hCG was 25.74±4.57 days in the C group, and was 34.71±2.93 days in the Co group, which was considered statistically significant （p〈0.05）. Conclusion ：Methotrexate and mifepristone for the medical treatment of ectopic pregnancy is safe, effective ,and economical.

关 键 词：输卵管妊娠 甲氨蝶呤 米非司酮 

分 类 号：R714.22[医药卫生—妇产科学]