氨甲喋呤静脉注射治疗异位妊娠78例分析

[目的 ]　探讨氨甲喋呤 (MTX)静脉注射治疗异位妊娠的疗效和适应证 ,并观察失败的相关因素。　 [方法 ]　对 64例治疗成功和 14例治疗失败病例的临床资料、包块直径以及血清 β -HCG值的变化进行对比分析。　[结果 ]　MTX治疗异位妊娠有效率为 82 .0 5 %,无急性内出血、停经天数小于 45d、异位妊娠包块直径 <5cm、血清 β -HCG <3 0 0 0IU/L为MTX治疗的适应证。当血清 β -HCG≥ 3 0 0 0IU /L ,治疗 3d后 β -HCG下降率 <3 0 %,或治疗 3d后包块直径增大时治疗极有可能失败。　 [结论 ]　MTX治疗异位妊娠疗效满意 ,早期诊断和严格选择应用对象是成功的关键

Analysis of 78 eases of ectopic pregnancy treated by intravenous injection of methotrexate

[Objective] To evaluate the efficacy and the related factors for the failure in treatment of ectopic pregnancy by intravenous injection of methotrexate (MTX). [Methods] The clinical data of changes of mass diameter and serum β-HCG in 64 successfully treated cases and 14 failure ones were compared and analyzed. [Results] The successful rate of the MTX treatment was 82.05%. There was no acute intra-abdominal bleeding , the average days of gestation was < 45 days , the diameter of ectopic mass was <5cm in the largest dimension and the titer of serum β-HCG was <3000 IU/L were the main indications for medical treatment of ectopic pregnancy . When the serumβ-HCG exceeded 3000IU/L , its decreasing after 3 days MTX treatment was less than 30% or with in creasing of mass diameter , the treatment by MTX for ectopic pregnancy might fail . [Conclusion] Using MTX in treating ectopic pregnancy can bring satisfactory result. The key for success is early diagnosis and strict selection of the patients.