甲氨蝶呤联合米非司酮治疗未破裂型输卵管妊娠的价值

目的探讨甲氨蝶呤（methotrexate,MTX）联合米非司酮治疗输卵管妊娠的临床价值。方法对未破裂型输卵管妊娠患者127例随机分为观察组（63例）及对照组（64例）两组,观察组：MTX肌肉注射,0.4mg/kg×5d,米非司酮口服,50mg/次,2次/d,共6d;对照组：MTX肌肉注射,0.4mg/kg×5d,同时口服安慰剂1片,2次/d,共5天。治疗期间严密观察阴道流血、血β-人绒毛膜促性腺激素（β-humanchorionic gona-dotrophin,β-HCG）值降至正常时间及异位妊娠包块吸收时间,比较两组间的差异。结果平均住院时间、血β-HCG降至正常时间和异位妊娠包块的直径缩小观察组均明显优于对照组,差异具有统计学意义（P〈0.05）。两组间在不良反应方面差异无统计学意义。结论 MTX联合米非司酮可提高未破裂型输卵管妊娠的治疗成功率,优于单用MTX,值得临床推广应用。

Clinical value of Methotrexate combined with Mifepristone for unruptured tubal pregnancy

Objective To study the clinical value of Methotrexate combined with Mifepristone treated for unruptured tubal pregnancy. Methods Totally 127 patients with unruptured tubal pregnancy were collected and randomly divided into observe group with 63 cases and treatment group with 64 cases. The patients in observe group were taken MTX intramuscular injection 0. 4 mg/kg for 5 days and Mifepristone 50 mg/d orally with twice one day for 6 days. While The other patients in treatment group were taken MTX 0.4 mg/kg for 5 days, intramuscular injection, at the same time an oral placebo, twice/day for 5 days. In the period of the treatment, the volume of vaginal bleeding, the time of β - human chorionic gonadotrophin （ β - HCG） decreased to the normal and absorption time of ectopic pregnancy mass were closely observed and the difference of which between the groups were compared. Results The volume of vaginal bleeding, the time of β - HCG decreased to the normal and absorption time of ectopic pregnancy mass in observation group were significantly better than that in control group and the difference was significant （ P 〈 0.05 ） between two groups. The difference of the adverse response between two groups was no statistically significant （ P 〉 0.05 ）. Conclusion Methotrexate combined with Mifepristone can improve the success rate in treatment of un- ruptured tubal pregnancy and which was better than Methotrexate alone. The method of Methotrexate combined with Mifepristone is worthy of clinical application.