注射MTX加米非司酮治疗未破裂输卵管妊娠的疗效评价

目的 探讨经阴道超声穿刺注射MTX(甲氨蝶呤)加口服米非司酮治疗未破裂型输卵管妊娠的疗效.方法 观察组:采用经阴道超声穿刺注射MTX加口服米非司酮治疗,先用甲氨蝶呤(MTX)20 mg经阴道超声引导下注入异位妊娠病灶,治疗后当天口服米非司酮5 0mg,每日2次,连用4天.对照组:采用口服米非司酮5 0mg,每日2次,连用4天.结果 经阴道超声穿刺注射MTX加口服米非司酮治疗,成功率为90%,明显高于对照组.观察治疗期间病情变化,发现疗效与血β-HCG高低及盆腔包块大小、有无心管搏动有关.结论 经阴道超声穿刺注射MTX加口服米非司酮治疗未破裂型输卵管妊娠安全有效,适用于生命体征平稳、无剧烈腹痛、无心管搏动及血β-HCG＜3000mIU/ml的未破裂型输卵管妊娠,成功率明显高于对照组.

Injection MTX Oral Mifepristone in Treatment of Unruptured Tubal Pregnancy

Objective To evaluate the effect of injection MTX by transvaginal ultrasound guided and oral mifepristone on treating unrupture tubal pregnancy.Methods The observing group:treated with mifepristone 50mg po Bidx4, MTX 20mg injection by transvaginal ultrasound guided, the control group treated with mifepristone 50mg po Bidx4. Results The successful of the observing group was 90% which was significantly higher than that of the control group. The effect of treatment was related to serum HCG leves and whether there was embryos with cardiac activity or not.Conclusion The treament of unruptured tubal pregnancy with injection MTX by transvaginal ultrasound guided and oral mifepristone is safe and effective.It is suitable for the unruptured tubal pregnancy with the combination of methotrexate and mifepristone is and effective.It is suitable for the unruptured tubal pregnancy with stable vital signs,but without acute abdominal pain or embryonic cardiad activity and HCG <30000mIU/ml.