甲氨蝶呤(31例)、米非司酮(31例)及联合(32例)治疗异位妊娠

目的:探讨甲氨蝶呤和米非司酮联合治疗 异位妊娠的效果。方法:将94例病人分为甲氨蝶呤 单次注射(A组,31例)、单服米非司酮(B组,31 例)及口服米非司酮后再单次注射甲氨蝶呤(C组, 32例)进行比较。A组:单次肌内注射甲氨蝶呤 50mg·m-2,1wk后血绒毛膜促性腺素(β HCG)无 下降趋势,可再注射1次。B组:单服米非司酮 50mg,bid×3d。C组:口服米非司酮50mg,bid,连 服2d,d3肌注甲氨蝶呤40mg·m-2。结果:A,B, C组的治愈率分别为68%,64%,88%。A组与B 组之间无明显差异(P>0.05),A,B两组与C组之 间有明显差异(P<0.05)。血绒毛膜促性腺素(β HCG)转阴时间:A,B,C三组分别为(20±s7)d, (21±7)d,(12±4)d。C组与A,B两组间有明显 差异(P<0.05),而A组与B组之间无明显差异(P> 0.05);C组较A,B两组能明显缩短血β HCG降至 正常范围的时间,提高治疗成功率。腹腔内出血而 行手术病例,A,B两组各2例,C组1例。结论:甲 氨蝶呤和米非司酮联合治疗异位妊娠,疗效高,不良 反应小,值得临床推广。

Efficacy of methotrexate(31 patients),mifepristone (31 patients) and methotrexate combined with mifepriston (32 patients) in treatment of ectopic pregnancy

AIM: To investigate the efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy. METHODS: Ninety-four patients were divided into Group A (n=31), group B (n=31) and group C (n=32). group A was treated with single methorexate injection 50 mg·m -2, im, group B with mifepristone 50 mg, po, bid, for 3 d, and group C with mifepristone 50 mg, po, bid for 2 d and methorexate injection 40 mg·m -2, im at d 3. RESULTS: The rate of cure in group A, group B, and group C were 61%, 64% and 88%. There was no difference between group A and group B (P>0.05), was significant difference between group A and group B; group B and group C (P<0.05). The time of blood β-HCG in group A, B, C was (20±7), (21±7), (12±4) d. There was significant difference between group C and group A, B (P<0.05) and no difference between group A and group B (P>0.05). Group C shew great differences in shortening the time of blood β-HCG, restoring to normal level, and raising cured rate, and which were greater than those of group A and group B. CONCLUSION: The treatment of ectopic pregnancy with the combination of methotrxate and mifepristone is safe and effective. It has high successful rate and minor adverse reaction.