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论著:甲氨喋呤联合米非司酮治疗异位妊娠
Comparison of the Efficacy of Different Administration of Methotrexate and Mifepristone in Patients with Ectopic Pregnancy
傅红梅 胡琴
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作者单位:江苏省句容市人民医院妇产科
中文关键字:异位妊娠;超声引导介入治疗;甲氨喋呤;米非司酮
英文关键字:Ectopic pregnancy; Ultrasound–guided intervention; MTX; Mifepristone
中文摘要:目的:探讨甲氨喋呤(MTX)不同的给药方式联合米非司酮保守治疗异位妊娠的临床疗效。方法:回顾分析2005年1月—2010年12月确诊为异位妊娠行MTX联合米非司酮保守治疗的103例异位妊娠患者的临床资料。所有患者按不同的给药方式分为A、B、C 3组,其中A组35例,肌肉注射MTX加口服米非司酮;B组41例,静脉滴注MTX加口服米非司酮;C组27例,在超声引导下穿刺异位妊娠囊注入MTX加口服米非司酮。比较3组患者的治疗成功率、血β人绒毛膜促性腺激素(β-HCG)值下降率及用药后不良反应发生率。结果:(1)3组患者治疗成功率分别为A组71.4% (25/35)、B组82.9% (34/41)、C组96.3%例(26/27)。3组患者治疗成功率差异有统计学意义(P<0.05);(2)治疗前后血β-HCG值下降率分别为A组 (44.9±7.5)%、B组(54.7±2.9)%、C组(63.0±6.2)%。3组患者治疗前后血β-HCG值下降率差异有统计学意义(P<0.01);(3)不良反应发生率A组和B组间差异无统计学意义(P>0.05),而A组和C组间、B组和C组间差异有统计学意义(P<0.05),C组的不良反应发生率最小。结论:对早期未破裂型异位妊娠,在超声引导下穿刺异位妊娠囊注入MTX加口服米非司酮治疗安全、可行、疗效肯定。
英文摘要:Objective: To investigate the curative effect of different methotrexate(MTX) administrations combined with mifepristone in the conservative treatment of ectopic pregnancy. Methods: Retrospective analyze the clinical records of 103 cases of ectopic pregnancy admitted to Jurong City People’s Hospital from January 2005 to December 2010. Divide into 3 groups by the way of MTX administration. Group A:35 cases treated with MTX im, Group B:41 cases treated with MTX ivgtt, Group C:27 cases treated with ultrasonography guided ectopic gestational sac injection of MTX. All the groups were treated with oral mifepristone meanwhile. Record the successful rates and adverse effects after treatments. Then statistically analyze the results to evaluate the efficacy of different MTX administration combined with mifepristone in the conservative treatment of ectopic pregnancy. Results: 1) Successful rate:Group A 71.4%(25 cases),Group B 82.9%(34 cases),Group C 96.3%(26 cases).Successful rates showed statistically significant difference in the 3 groups(P<0.01),Group C was highest. 2) Decreased rate of serum β-HCG after treatment: Group A (44.9±7.5)%, Group B (54.7±2.9)%, Group C (63.0±6.2)%.Decreased rates of β-HCG showed statistically significant difference in the 3 groups(P<0.05),Group C showed the largest rate of decline.3) Adverse reactions: Statistal analysis showed adverse reaction rates were similar in Group A and B, and they were not significantly different(P>0.05),while there were significant difference between Group A and C,Group B and C (P<0.05),Group C showed the minimum adverse effects. Conclusions: To unruptured ectopic pregnancy, ultrasound–guided injection of MTX combined with oral mifepristone treatment is an safe,feasible and effective treatment.
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