不同剂量甲氨蝶呤保守治疗异位妊娠临床疗效观察

目的:观察不同剂量甲氨蝶呤保守治疗异位妊娠的临床疗效。方法:将2001年6月～2011年5月早期未破裂异位妊娠患者210例随机分为A组、B组和C组,每组各70例。A组给予甲氨蝶呤0.4 mg.kg-1.d-1肌内注射,连用5天;B组给予甲氨蝶呤1.0 mg.kg-1.d-1单次肌内注射;C组给予甲氨蝶呤1.0 mg/kg肌内注射,隔日1次,四氢叶酸0.1 mg/kg肌内注射,隔日1次,共4次。观察3组血β-人绒毛膜促性腺激素(β-HCG)水平变化,并应用B超复查异位病灶的变化。结果:治疗1周后血β-HCG下降幅度:C组>B组>A组;血β-HCG水平下降至正常时间:C组0.05)。结论:甲氨蝶呤不同剂量、不同给药方式保守治疗异位妊娠均有一定疗效,但大剂量、多次给药配合解毒治疗,作用更迅速。

Observation on the clinical efficacy of conservative treatment with different doses of methotrexate for ectopic pregnancy

Objective:To observe the clinical efficacy of conservative treatment with different doses of methotrexate for ectopic pregnancy. Methods:Two hundred and ten patients with early unruptured ectopic pregnancy from June 2001 to May 2011 were randomly divided into A group,B group,and C group,70 patients in each group.The patients in A group were treated with intramuscular injection of methotrexate(0.4 mg·kg-1·d-1) for successive five days;the patients in B group were treated with intramuscular injection of methotrexate(1.0 mg·kg-1·d-1);the patients in C group were treated with intramuscular injection of methotrexate(1.0 mg/kg)(every other day) and tetrahydrofolic acid(0.1 mg/kg)(every other day) for four times.The changes of blood β-human chorionic gonadotropin(β-HCG) levels in the three groups were observed,ultrasonography was used to reexamine the changes of ectopic lesions. Results:The extent of decrease of blood β-HCG after treatment for one week: C group>B group>A group;the time for blood β-HCG reducing to normal level: C group0.05). Conclusion:Different doses of methotrexate used with different administration methods have a certain curative effect in conservative treatment of ectopic pregnancy,but large dose and multiple-dose methotrexate combined with detoxification treatment can take more rapid effect.