异位妊娠3种保守治疗方法临床疗效比较

目的探讨3种保守治疗方法治疗异位妊娠的临床疗效。方法 60例异位妊娠患者分为米非司酮组、氨甲蝶呤(MTX)肌肉注射组和MTX胚囊注射组,每组20例;治疗前后检测3组患者血β-人绒毛膜促性腺激素(β-HCG),治疗成功患者在治疗后第3次月经干净后3～7 d行输卵管碘油造影。结果 3组间治疗成功率比较差别无统计学意义(P>0.05);米非司酮组和MTX肌肉注射组血β-HCG浓度恢复正常时间及住院时间比较差别无统计学意义(P>0.05),MTX胚囊注射组血β-HCG浓度恢复正常时间及住院时间较米非司酮组和MTX肌肉注射组明显缩短,差别有统计学意义(P<0.05);3组输卵管复通率比较差别无统计学意义(P>0.05)。结论 MTX阴道超声指导下胚囊局部注射可缩短疗程,较早判断预后;米非司酮用药方便,适合于门诊患者。

Effects of three expectant treatment methods for ectopic pregnancy

Objective To discuss the clinical effects of three expectant treatment methods for ectopic pregnancies.Methods Sixty patients with ectopic pregnancies were divided into mifepristone group,methotrexate(MTX) intramuscular injection group and MTX embryonary sac injection group,twenty patients in each group.The serumβ-human chorionic gonadotropin(β-HCG) was detected before and after treatment,the patients with successful treatment were carried out hysterosalpingographyβ-7 days after the third catamenia termination.Results There was no significant statistical difference in treatment successful rate among three groups(P>0.05).There was no significant statistical difference in the time of serumβ-HCG recovery normal and length of stay hospital between MTX muscle injection and mifepristone group(P>0.05),but the time of serumβ-HCG recovery normal and length of stay hospital were shorter in MTX embryonary sac injection group(P<0.05).There was no significant statistical difference in repatency rate among three groups(P>0.05).Conclusion MTX local injected ectopic gestational sac guided by transvaginal ultrasound can shorten the course of treatment,judge the prognosis early.Mifepristone is convenience used by out-patient clinic patients.