甲氨蝶呤不同途径给药治疗输卵管妊娠的疗效分析

目的 探讨不同途径注射甲氨蝶呤（MTX）治疗输卵管妊娠的疗效.方法 我院确诊的输卵管妊娠患者150例,随机分为3组,每组50例.A组：米非司酮＋中药；B组：MTX单次肌肉注射＋米非司酮＋中药；C组：经后穹窿穿刺盆腔注射MTX 50 mg＋米非司酮＋中药.用药期间观察患者一般生命体征,治疗后第4、7和10天复查测血β-HCG.治疗后1周B超监测包块大小,并记录患者β-HCG转阴时间及住院时间.结果 C组有45例患者达到治愈标准,治愈率达90.0％,均明显高于A组和B组（P＜0.05）.C组血β-HCG转阴时间、患者住院时间均较A、B组明显缩短（P＜0.05）.结论 治疗输卵管妊娠,经后穹窿穿刺盆腔注射MTX疗效优于肌肉注射MTX,成功率达90％,并具有简单、不良反应少等优点.

Analysis of clinical efficacy of different routes of methotrexate administration in salpingocyesis

Objective To discuss clinical efficacy of different routes of methotrexate administration in salpingocyesis.Methods 150 cases of salpingocyesis were randomly divided into three groups,50 cases in each group.Group A received mifepristone ＋ traditional Chinese medicine; group B received MTX intramuscular injection ＋ mifepristone ＋ traditional Chinese medicine; group C received MTX pelvic injection via posterior fomix ＋ mifepristone ＋ traditional Chinese medicine.Vital signs of patients were observed during the treatment.Blood β-HCG was measured 4,7,10 days after treatment.The size of mass was measured by B-mode ultrasound 1 week after treatment.The clearance time of β-HCG and hospital stays were recorded.Results 45 patients were cured successfully in group C,with the cure rate of 90.0％,obviously higher than those in group A and group B （P ＜ 0.05）; the clearance time of β-HCG and hospital stays were shorter （P ＜ 0.05）.Conclusions MTX pelvic injection via posterior fornix characterized by easy operation and less side effect,is a better therapy method for salpingocyesis in comparison with intramuscular injection.