异位妊娠保守治疗中二次使用天花粉蛋白的临床研究  

Clinical research on secondary use of trichosanthin in conservative treatment of ectopic pregnancy

作　　者：王晨曦[1] 戴良图[1] 曾敏华[1] 

机构地区：[1]解放军第四一一医院妇产科,上海200081

出　　处：《海军医学杂志》2012年第5期308-310,共3页Journal of Navy Medicine

摘　　要：目的探讨在异位妊娠保守治疗中二次使用天花粉蛋白的临床意义。方法 40例异位妊娠者,首次选用天花粉蛋白保守治疗后7 d出现血中人绒毛膜促性腺激素(β-HCG)反弹,需继续巩固治疗。根据患者知情选择分为3组:A组16例,选择米非司酮巩固治疗;B组12例,选择氨甲喋呤(MTX)巩固治疗;C组12例,选择二次使用天花粉蛋白巩固治疗。观察每组血βHCG下降至100 U/L的情况及所需时间,分析不良反应情况。结果 A、B、C组巩固治疗的有效率分别75.0%、83.3%、100%,C组住院所需时间明显低于A、B组(P<0.05),且与入院时血β-HCG水平呈正相关。结论二次使用天花粉蛋白巩固治疗异位妊娠临床效果显著,但需严格把握适应证及预防过敏性反应。Objective To discuss clinical value of secondary use of trichosanthin （TCS） in conservative treatment of ectopic pregnancy. Methods Forty cases of ectopic pregnancy were chosen in our study. Serum β-human chorionic gonadotropin （β-HCG） level rebounded in all the cases, following 7 days of conservative treatment with TCS and further after treatment was required. With the knowledge of the patients, the cases were divided into 3 groups： the A group （16 cases） which received mifepristone as after treatment; the B group （12 cases） which received methotrexate （MTX） as after treatment; and the C group （also 12 cases） which had secondary use of trichosanthin as after treatment. The time required for serum β-HCG of each group to drop to less than 100 U/L was calculated and adverse effects were analyzed. Results Effective rates for the 3 groups were 75% , 83.3% and 100% respectively. The duration of stay in the hospital for patients in the C group was significantly shorter than those of the patients in the A and B groups （ P 〈 0.05 ）, and was positively correlated with the level of serum β-HCG, when they were admitted into the hospital. Conclusion Significant therapeutic effect could be seen with the secondary use of TCS for the after treatment of ectopic pregnancy. Nevertheless, the important thing was the indication and measures should be taken to guard against any possible allergic reactions.

关 键 词：异位妊娠 天花粉蛋白 过敏反应 米非司酮 氨甲喋呤 

分 类 号：R714.22[医药卫生—妇产科学]