异位妊娠药物治疗的临床观察

目的评价不同药物组合治疗异位妊娠的效果。方法 40例早期异位妊娠随机分为A、B两组,A组18例:甲氨蝶呤1 mg/kg单次肌内注射,当天开始口服米非司酮片50 mg,12 h 1次,连续3 d。B组22例:甲氨蝶呤1 mg/kg单次肌内注射后,第2天开始口服传统中药异位妊娠方加味,连用7 d。比较两组的治愈率及不良反应情况。结果 A组15例治愈(83.3%),3例因1周以后血促绒毛膜性腺激素无下降,患者要求手术治疗。B组19例治愈(86.3%),3例因患者保守治疗5～7 d后突感下腹剧痛而采取手术治疗。A组不良反应发生率72.2%(13/18),B组27.2%(6/22),两组比较差异有统计学意义(P<0.05)。结论甲氨蝶呤肌内注射并口服中药治疗异位妊娠具有不良反应小、依从性强等优势,更适合临床推广。

Clinical Observation of Ectopic Pregnancy Treated with Medicines

Objective To evaluate the effect of treatment of ectopic pregnancy with different medicine combination.Methods 40 patients diagnosed with early ectopic pregnancy were divided into two groups:group A and B group.18 cases in group A were given MTX by i.m.(1mg/kg)at a time and meanwhile were treated with mifepristone tablets.q.12.P.O.for three days.22 cases in group B were injected MTX(1mg/kg)at a time and on the second day began to be treated with oral traditional Chinese medicines which were adjusted for 7 days.The effect and toxicity of the two groups were compared.Results In group A 15 patients were cured(83.3%)and other 3 cases required operative treatment without the serum β-HCG reduction after one week.19 cases in group B were cured(86.3%).Other 3 cases were offered operative treatment because of the acute lower abdominal pain after conservative treatment for 5-7 days.The occurrence rates of adverse effect were 72.2%(13/18)and 27.2%(6/22)for group A and B respectively.There were significant differences between the two groups(P<0.05).Conclusion Compared with medicine combination of MTX and mifepristone which was applied to ectopic pregnancy the medicine combination of MTX by i.m.and traditional Chinese medicines is of less adverse reaction and better compliance,which should be more suitable to be applied widely in the clinical treatment.