高水平血βhcg输卵管妊娠保守治疗方案的对比分析.pdf

高水平血β -HCG 输卵管妊娠保守治疗方案的对比分析 【摘要】目的观察高水平血β -HCG 输卵管妊娠不同保守治疗方案的临床疗效。 方法 将66 例输卵管妊娠同意保守治疗患者随机分为两组各33 例。治疗组采用 复方米非司酮片并肌肉注射MTX 同时口服本院协定处方宫外孕方并配合中药口 服；对照组不采用复方米非司酮片治疗，其余西医和中医治疗同治疗组。结果 临床疗效总有效率治疗组为93.9%，对照组为72.7%，两组比较，差异有显著性 意义(P＜0.05)；治疗组18 例1 个疗程治愈，对照组8 例1 个疗程治愈，两组 比较，差异有非常显著性意义(P＜0.01)，两组阴道流血时间及平均住院时间比 较，差异有非常显著性意义(P＜0.01)，两组在血β -HCG 转阴时间和盆腔包块 消失时间方面，差异有显著性意义(P＜0.05)。结论 复方米非司酮协同MTX 及 中药治疗输卵管妊娠，能明显提高较高水平血β -HCG 输卵管妊娠的治愈率，明 显缩短阴道流血时间及患者住院时间，能促进血β -HCG 转阴及盆腔包块消失， 而且1 疗程治愈率高，其治疗方案有一定副作用，但控制在2 个疗程范围内用 药是安全的，值得临床推广应用，甲氨蝶呤多次方案并多途径联合用药的中西 医结合治疗方法治疗血β -HCG≥2000U ／L 且＜8000U ／L 的异位妊娠患者在临床 是可行的，至于远期疗效则有待进一步研究。 【关键词】输卵管妊娠 复方米非司酮 高水平血β -HCG 保守治疗 【Objective】 To observe the clinical efficacy of high level serum β -HCG tubal pregnancy different conservative treatment . Methods: 66 cases of tubal pregnancy agree with conservative treatment， patients were randomly pided into two groups . The treatment group were treated with the compound mifepristone tablets and intramuscular injection of MTX at the same time oral prescription Court Agreement ectopic pregnancy side and with the oral medicine; the control group did not use the compound mifepristone tablets in the treatment， the rest of Western medicine and Chinese medicine treatment and the treatment group. Results: The clinical efficacy of the total efficiency of the treatment group was 93.9%， 72.7% in the control group， the two groups， the difference was significant (P 0.05); treatment group 18 cases a course of treatment to cure， control group of eight cases a course of treatment cured， the two groups， the difference was very significant (P 0.01)， two sets of vaginal bleeding and the average length of stay， the difference was very significant (P 0.01)， the two groups in serum β -HCG negative time and pelvic mass disappearance time， the difference was significant (P 0.05). Conclusion: The compound mifepristone collaborative MTX， and traditional Chinese medicine treatment of tubal pregnancy， c