甲氨蝶呤联合米非司酮治疗宫外孕的疗效观察

目的:观察甲氨蝶呤(MTX)联合米非司酮治疗宫外孕的临床效果。方法:选择我院2010年1月-2011年1月收治的80例宫外孕患者,随机分为联合组(MTX+米非司酮)与对照组(米非司酮),比较2组治疗后的疗效和治疗前后血β-人绒毛膜促性腺激素(β-HCG)、B超盆腔包块的情况及副作用。结果:联合组治疗宫外孕的治愈率为90.0%,明显优于对照组的治愈率(60.0%),差异有统计学意义(P<0.01);联合组用药后血β-HCG明显下降,B超显示盆腔包块明显缩小,与对照组比较差异有统计学意义(P<0.01);2组常见的副作用主要为胃肠不适、口腔溃疡、皮疹、肝功能异常、白细胞减少等,联合组副作用发生率与对照组比较差异无统计学意义(P>0.05),所有副作用均经对症处理后好转或消失。结论:MTX联合米非司酮治疗宫外孕的治愈率高,副作用小,可以明显降低β-HCG水平。

Efficacy Observation of Methotrexate Combined with Mifepristone in the Treatment of Ectopic Pregnancy

OBJECTIVE： To observe the clinical efficacy of methotrexate （MTX） combined with mifepristone in the treatment of ectopic pregnancy. METHODS： From Jan. 2010-Jan. 2011 in our hospital, 80 cases of ectopic pregnancy were randomly divided into combined treatment （MTX＋mifepristone） group and control group （mifepristone alone）. The treatment effect, β-HCG, type-B ultrasonic pelvic mass and side effects of 2 groups were observed and compared before and after treatment. RESULTS： The successful rate of ectopic pregnancy relieve in combined treatment group was 90.0%, which was significantly better than that of control group, there was significant difference （P0.01）. The serum level of β-HCG in combined treatment group decreased significantly, type-B ultrasonic pelvic mass reduced significantly, and there was significant difference between combined treatment group and control group （P0.01）. Common side effects of 2 groups mainly were gastrointestinal discomfort, mouth ulcers, skin rash, abnormal liver function and leucopenia. There was no significant difference in the incidence of side effect between combined group and control group （P0.05）. All side effects had improved or disappeared after treatment. CONCLUSION： MTX combined with mifepristone can be used for the treatment of ectopic pregnancy with high successful rate and little side effects. It can significantly reduce the level of β-HCG.