甲氨蝶呤联合米非司酮治疗异位妊娠疗效观察

目的探讨甲氨蝶呤联合米非司酮治疗异位妊娠的临床疗效。方法2007年6月-2012年12月收治确诊为异位妊娠并适合保守治疗的患者9660。96例患者随机分为两组，A组486例（其中血清孕酮浓度〉10ng／ml 18例，〈10ng／mL30例1，第1日甲氨蝶呤50mg／m。单次肌肉注射，同时第1日口服米非司酮50mg，每日2次，连服3d；B组48例（其中血清孕酮浓度〉10ng／mL1760，〈10ng／mL31例），采用甲氨蝶呤50mg单次肌肉注射。两组均于1周后查血β-HCG，如血β-HCG〈15％重复第二疗程给药，最多2疗程。1周后了解监测血β-HCG下降情况，B超检查包快大小，观察药物不良反应。结果甲氨蝶呤联合米非司酮治疗异位妊娠：治疗前孕酮低于10ng／mL时治愈率与单用氨甲喋呤疗效相当，但治疗副反应明显增加；治疗前孕酮高于10ng／mL时治愈率明显高于单用氨甲喋呤组。

The Curative Effect of Mifepristone Combined with Methotrexate in Treating Ectopic Pregnancy

Objective To investigate the clinical effect of mifepristone combined with methotrexate in treating ectopic pregnancy. Methods 96 ectopic pregnancy cases with conservative treatment from June 2007 to December 2012 were diagnosed. 96 patients were randomly divided into two groups, 48 cases in A group, first days 50mg/m^2 single intramuscular injection of methotrexate, at the same time first day oral mifepristone 50mg, 2 times a day, and even served 3 days; 48 cases in B group, 50mg single intramuscular injection with methotrexate. In the two groups after 1 weeks of blood β -HCG, such as blood β -HCG〈15% repeat second courses were administered,up to 2 cycles. 1 weeks after the understanding of monitoring of blood β -HCG down, B ultrasound check package size, observation of adverse drug reaction. Results Mifepristone combined with methotrexate in treating ectopic pregnancy： before treatment, the cure rate of progesterone below 10ng/ml with single methotrexate treatment is effective, but side effects before treatment significantly increased; progesterone is higher before treatment was significantly higher than that of single use of methotrexate.