宫腔镜下经输卵管注射甲氨蝶呤与口服米非司酮联合在输卵管妊娠保守治疗中的应用  

Application of Hysteroscopic Injection of Methotrexate Combined with Oral Mifepristone in Conservative Treatment of Tubal Pregnancy

作　　者：白杨 BAI Yang(Department of Obstetrics and Gynecology, 23 Hospital, Yanjiao Development Zone, Sanhe, Hebei Province, 065201 Chin)

机构地区：[1]三河燕郊开发区二三医院妇产科

出　　处：《中外医疗》2019年第24期44-46,共3页China & Foreign Medical Treatment

摘　　要：目的分析米非司酮配合甲氨蝶呤(MTX)宫腔镜下输卵管注射用于输卵管妊娠治疗的可行性。方法方便选取2016年1月—2017年10期间83例输卵管妊娠者为研究对象,所有患者均采用MTX、米非司酮联合用药治疗,同时按数字表法随机分组,观察1组共40例(肌肉注射MTX+口服米非司酮)、观察2组43例(宫腔镜下输卵管注射MTX+口服米非司酮),观察两组疗效差异,检查两组血β-HCG、包块治疗前后差异,统计不良反应发生率。结果治疗后1周观察2组血β-HCG值(180.5±76.4)mIU/mL、包块大小(0.3±0.1)cm低于观察1组(239.5±81.7)mIU/mL、(0.7±0.2)cm(t=3.400、11.646,P<0.05);观察2组治愈率为95.3%,高于观察1组85.0%(χ^2=5.974,P<0.05);观察2组不良反应发生率为7.0%,低于观察1组17.5%(χ^2=5.128,P<0.05)。结论米非司酮口服配合MTX宫腔镜下输卵管注射用于输卵管妊娠治疗,临床治愈率高、不良反应少,患者包块消失、血β-HCG转阴用时短。Objective To analyze the feasibility of mifepristone combined with methotrexate (MTX) hysteroscopic tubal injection for tubal pregnancy treatment. Methods 83 patients with tubal pregnancy from January 2016 to October 2017 were convenient selected and enrolled. All patients were treated with MTX and mifepristone. At the same time, they were randomly grouped according to the digital table method. A total of 40 patients were observed in group 1 (intramuscular injection of MTX + oral rice Ketone), 43 cases in observation group 2 (hysteroscopic tubal injection MTX + oral mifepristone), observed the difference in efficacy between the two groups, the difference between the two groups of blood β-HCG, mass before and after treatment, statistical adverse reactions occurred. Results One week after treatment, the blood β-HCG value (180.5±76.4) mIU/mL and the size of the mass (0.3±0.1) cm of the observation group 2 were lower than those of the observation group 1 (239.5±81.7) mIU/mL,(0.7±0.2)cm(t=3.400,11.646, P<0.05);the cure rate of the of the observation group 2 was 95.3% higher than that of the observation group 1 of 85.0%(χ^2=5.974, P<0.05);the incidence of adverse reactions of the observation group 2 7.0% was lower than observed in group 1 by 17.5%(χ^2= 5.128, P<0.05). Conclusion Mifepristone is combined with MTX hysteroscopic tubal injection for tubal pregnancy treatment. The clinical cure rate is high and the adverse reactions are few, and the patient's mass disappears and the time for the blood β-HCG turning negative is short.

关 键 词：保守治疗 输卵管妊娠 甲氨蝶呤 米非司酮 输卵管注射 

分 类 号：R714[医药卫生—妇产科学]