异位妊娠化疗的多因素分析

目的：分析１１２例异位妊娠（活胚）采用甲氨蝶呤（ＭＴＸ）化疗效果及影响疗效的因素。方法：１１２例异位妊娠均采用ＭＴＸ肌注２０ｍｇ，每日一次，连续５天化疗。每周两次监测血β－ｈｃＧ值及Ｂ超，直至正常。结果：化疗有效，同时并用我所治疗宫外孕的中药促进异位妊娠包块吸收治愈１０６例，占９４．６％。余６例失败转手术。经逐步回归分析表明：治疗效果与化疗前患者的孕龄的长短、血β－ｈｃＧ值的高低、是否有胎心及阴道出血量、注射ＭＴＸ后副反应出现率有关；而与患者的年龄、异位妊娠包块的大小及治疗前腹痛发生率无统计学意义。结论：ＭＴＸ是目前对异位妊娠较为安全，有效的化疗药物。

MULTIPLE FACTOR ANALYSIS OF THE CHEMOTHERAPY OF ECTOPIC PREGNANCIES

Objectives:To make a therapeutic evaluation of the chemical methotrexate (MTX) and analyse some factors affecting it in 112 cases of viable ectopic pregnancies.Methods:112 cases of ectopic pregnancy were treated by intramuscular methotrexate 20 mg/d,total 5 days.The betahuman chorionic gonadotropin levels and B ultrasound were monitored two times per week till they became normal.All the cases received this regimen in inpatient service.Results:106 cases (94.6%) were successfully treated with MTX chemotherapy and Chinese medicinal herbs removing ectopic mass.The other six failed and switched to operation.The statistical test results were obtained by an analysis of stepwise regression.The efficacy was related to gestational ages,β hcG,fetal heart beat before treatment,vaginal bleeding before treatment and the side effects after injection of MTX;but there was not statistical significance with patient′s age,size of ectopic pregnant mass and the occurrence rate of abdominal pain before treatment.Conclusion:Up to date,MTX combined with Chinese medicinal herbs is the relatively safe and efficient remedy in treating ectopic pregnancy.