甲氨蝶呤两种应用方案联合米非司酮治疗异位妊娠的临床研究

目的：探讨两种不同方案的甲氨蝶呤联合米非司酮治疗异位妊娠的临床效果。方法：选取80例异位妊娠患者作研究对象，均为本院妇产科2010年2月-2013年2月收治，随机数字表法分组，0.4 mg/（kg·d）甲氨蝶呤联合米非司酮（A组）与1 mg/kg甲氨蝶呤联合米非司酮（B组）临床效果进行比较。结果：B组选取病例临床总有效率为100%，高于A组97%，两组比较差异无统计学意义（P〉0.05）。两组治疗前血β-hCG值比较差异无统计学意义（P〉0.05），治疗后第5天、第10天两组均有降低，但B组下降幅度显著高于A组（P〈0.05），两组治疗15 d、30 d差异无统计学意义（P〉0.05）。B组胃肠道反应率为17.5%，白细胞下降40%，A组分别为80%、82.5%，两组比较差异有统计学意义（P〈0.05）。结论：甲氨蝶呤采用1 mg/kg，与米非司酮联合治疗异位妊娠，可保证治疗效果，降低不良事件率，保障用药安全，满足了患者生育要求，具有非常积极的临床意义。

A Clinical Study of Two Application Schemes of Methotrexate Combined with Mifepristone in the Treatment of Ectopic Pregnancy

Objective：To discuss the clinical effects of two different schemes of methotrexate combined with mifepristone in the treatment of ectopic pregnancy. Method：80 patients with ectopic pregnancy were selected as the research objects,and all the patients were received in the obstetrics and gynecology of our hospital from February 2010 to February 2013,and they were randomly divided into group A with 0.4 mg/（kg·d）methotrexate combined with mifepristone and group B with 1 mg/kg methotrexate combined with mifepristone,then the clinical effects of the two groups were compared. Result：The total clinical effective rate of group B was 100%,and which was significantly higher than that of group A（97.%）,and the difference between the two groups was not statistically significant（P〉0.05）. There was no significant difference between the values of Blood beta hCG before treatment in the two groups（P〉0.05）,and which decreased in the two groups after treatment 5 d and 10 d,but group B decreased significantly higher than group A（P〈0.05）,after treatment 15 d and 30 d,there was no obvious difference（P〉0.05）. The gastrointestinal response rate of group B was 17.5%,and the drop rate of white blood cells was 40%,and that of group A was 80%and 82.5%respectively,and the differences were statistically significant（P〈0.05）. Conclusion：The therapy of methotrexate with 1 mg/kg combined with mifepristone in the treatment of ectopic pregnancy can guarantee the therapeutic effect,decrease the rate of adverse events,ensure the safety of drug use,meet the needs of patients with fertility,and has very positive clinical significance.