异位妊娠不同药物治疗和手术时机的选择

①目的观察甲氧蝶呤（MTX）联合米非司酮或中药治疗输卵管妊娠的疗效，探讨其手术时机和方式的选择。②方法100例异位妊娠患者随机分为MTX联合米非司酮治疗组（对照组）49例和MTX联合中药治疗组（中药组）51例，比较两组的治疗效果；③结果对照组41例治愈（83．7％），5例最终改为手术治疗；中药组43例治愈（84．3％），4例最终改为手术治疗。两组间疗效比较，差异无显著性（P〉0．05）。中药组副反应明显低于对照组（P〈0．05）；两组输卵管通畅试验比较差异有显著性（P〈0．05）。④结论MTX单次肌内注射联合中药治疗输卵管妊娠疗效较好，副反应少，再次宫内妊娠率高。对有生育要求的异位妊娠患者准确把握治疗过程中手术时机和方式，降低输卵管切除率。

Choice of different drug treatment and operation opportunity about heterotopic pregnancy

Objective To observe therapeutic effects of methotrexate combining mifepristone or Chinese crude drug on tubal pregnancy treatment and explore the choice of operation opportunity and way.Methods 100 heterotopic pregnancy patients were divided into two groups randomly:one group patients with MTX combining mifepristone (control group,49 cases) and another group patients with MTX combining Chinese crude drug (treatment group,51 cases), and therapeutic effects were compared.Results 41 patients in control group were cured (83.7%),5 patients were operated at last,while 43 patients in treatment group were cured(84.3%),4 patients were operated at last,there was no significant difference between two groups(P>0.05).Side effect in treatment group was lower than that in control group(P<0.05),and there was significant difference in smooth of fallopian tube between two groups(P<0.05).Conclusion Curative effect of MTX intramuscular injection single once combining Chinese crude drug on fallopian pregnancy treatment was better,side effect was few and intrauterine pregnancy rate was high again.It was important to grasp accurate operation opportunity and way during the therapy process and decrease tubal resection rate for heterotopic pregnancy patient requiring procreation.