以不同给药方式治疗异位妊娠126例

目的探讨甲氨蝶呤三种给药方式联合米非司酮治疗异位妊娠的疗效及不良反应。方法对126例异位妊娠患者随机分为A、B、C三组。A组42例:甲氨蝶呤0.4mg/(kg?d),连续肌内注射5d;B组:42例甲氨蝶呤0.4mg/(kg?d),隔日肌内注射3d;C组42例:甲氨蝶呤1mg/kg,单次肌内注射,三组均同时联合米非司酮25mg,2次/d口服,连续用3d。观察3组血β人绒毛膜促性腺激素(β-HCG)下降程度和药物不良反应等指标。结果与治疗前比较,3种给药方式联合米非司酮治疗后血β-HCG下降明显,差异有统计学意义(P<0.05),但3种用药方案对血β-HCG下降程度比较差异无明显统计学意义(P>0.05);另外从3者用药后的不良反应发生率来看,单次给药的不良反应要小(P<0.05)。结论 3种甲氨蝶呤给药方式联合米非司酮治疗异位妊娠的疗效无明显差异,但单次给药的不良反应较少,安全性高,值得临床推广。

Comparison Research on the Curative Effect of Ectopic Pregnancy Combined with Methotrexate Different Use Method and Mifepristone of Methotrexate

Objective To observe the therapeutic effect of ectopic pregnancy combined with Methotrexate（MTX）and Mifepristone. Methods 126 patients with ectopic pregnancy and conforming to the conservative treatment condition were randomly divided into three groups. 42 patients in A group were treated by MTX, once a day; 42 patients in B group were treated by MTX, every other day; 42 patients in C group were treated by MTX just once. The rate of decay of β-HCG, clearance time, minification of nodule and the incidence of untoward effect were observed after 10days. Results Each before and after the treatment beta HCG decline difference are statistically significant; these is no difference in the improvement of the cure rate and rate of decay of β-HCG among A group、B group and C group （P0.05）; adverse reaction of C group is smaller than A group and B group （P0.05）. Conclusion these is no different effect on ectopic pregnancy, but adverse reaction of single injection of MTX is smaller.