氨甲喋呤、米非司酮和丙酸睾丸酮联合治疗异位妊娠的研究

目的　探讨氨甲喋呤 (MTX)、米非司酮 (MST)和丙酸睾丸酮 (TP)联合治疗异位妊娠的效果。方法　对 76例病人随机分为 3组 ,A组 (2 7例 )给予MTX 5 0mg加 30ml生理盐水隔日静注× 3d ,隔日用 15mg四氢叶酸钙 (CF)肌注解毒 ,同时口服MST 5 0mgBid× 6d ,肌注TP 5 0mgqd× 3d。B组 (2 6例 )用MTX和CF和MST。C组 2 3例 (对照组 )单用MTX和CF。治疗期间所有病例均定期查B超和血 β -hCG结果。 结果　A组和B组的成功率分别为 85 2 %和 84 6 % ,二者之间无显著性差异 (P >0 0 5 ) ,但显著高于C组 73 9% (P <0 0 1)。结论　氨甲喋呤、米非司酮和丙酸睾丸酮联合治疗异位妊娠的效果较佳 ,值得临床推广应用。其应用的适应症是肝、肾和凝血功能正常 ,B超检查异位妊娠包块直径 <4cm ,无急性内出血 ,血 β -hCG <5 0 0 0U/L。

ANALYZE THE CLINICAL EFFECT OF COMBINATION OF METHOTREXATE, MIFEPRISTONE AND TESTOSTERONE PROPIONATE IN THE TREATMENT OF ECTOPIC PREGNANCY

Objective To investigate the clinical effect of combination of methotrexate (MTX), mifepristone (MFT) and testosterone propionate (TP) in the t reatment of ectopic pregnancy. Methods 76 cases of ectopic pre gnancy were divided into three groups. Group A was treated with 50mg MST and TP and MTX; Group B was treated with 50mg MST and MTX; Group C (control group) wa s treated with 50mg MTX; all groups were given citrovorum factor for rescue. Th e B-ultrasonic and serum β-hCG were monitored regularly in therapy course. Results The successful rates of Group A and B were 85.2% and 8 4.6% respectively and the successful rates in those two groups were no signific ant difference (P>0.05), but higher than that of Group C (P<0.01). Conclusion The combinations of MTX and MFT and TP in the treatment of ectopic pregnancy were effective, but we should strictly grasp the medical t reatment indications of ectopic pregnancy, such as normal liver, kidney and coag ulation functions, ectopic mass in the largest dimension <4 cm monitored by B-ul trasonic, no acute intra-abdominal bleeding and the level of serum β-hCG< 5 00 0 U/L.