不同甲氨蝶呤应用方案联合米非司酮治疗异位妊娠的对照研究.docxVIP

不同甲氨蝶吟应用方案联合米非司酮治疗异位妊娠的对照研究 陆志红1倪南鹰2 (1启东市第五人民医院 江苏南通226231) (2屮国人民解放军第八一医院妇产科江苏南京210000) 【摘要】目的 探讨和对比不同甲氨蝶吟(MTX)应用方案联合米非司酮治 疗异位妊娠的临床疗效和不良反应发生率。方法选取本院确诊为异位妊娠患者 80例，随机分为A组和B组，每组40例。其屮A组采用一次性给药方式，B组 采用分次给药方式。两组均口服同剂量米非司酮。观察治疗7 d后患者的临床有 效率和不良反应发生率。结果A组总有效率为90%； B组总有效率为62.5%, 差异有显著统计学意义(P0.01)o A组不良反应总发生率为10% (4/40),与B组 的15% (6/40)无显著差异(P0.05)o结论 甲氨蝶吟一次性给药可有效提高异 位妊娠患者的临床疗效，减少不良反应发生率，值得在临床推广应用。 【关键词】甲氨蝶吟 米非司酮 异位妊娠 对照研究 【屮图分类号】R714.22 【文献标识码】A 【文章编号】2095-1752 (2013) 33-0090-02 【Abstract] Objective To discus and compare the clinical effect and adverse reaction rate of different administrative methods of Methotrexate (MTX) concomitant with Mifepristone on patients with ectopic pregnancy. Methods A total of 80 patients with ectopic pregnancy in out hospital were divided into A group and B group, 40 cases for each group, in which MTX was to A group in 1 time and B group in several times, while Mifepristone was given to both groups in same dosage and administrative method. Clinical effect and adverse reaction rate of both groups were observed and compared after 7-d treatment. Results The total effective rate of A and B groups were 90% and 62.5% respectively, and there was sign讦icant differenee (P0.01), whereas the differenee in adverse reaction rate was not sigrdficant between A group (10%, 4/40) and B group (15%, 6/40) (P0.05). Conclusion The administration of MTX in 1 tie concomitant with Mifepristone can improve the clinical effect and reduce the adverse reaction rate for patients with ectopic pregnancy, deserving to be widely applied in clinic. 【Key Words] Methotrexate Mifepristone ectopic pregnancy comparative study 异位妊娠以输卵管妊娠最常见，是妇科急腹症之一，发生率约为1%⑴。患 者常因破裂岀血或流产导致腹腔大岀血，其则危及生命，而传统的手术治疗方案 是切除患侧输卵管，容易造成患者不孕。甲氨蝶吟联合米非司酮是临床上治疗异 位妊娠的最常用药物，不仅可以减少患者手术带来的机体损伤和病痛，还能保留 生育能力，但临床对于甲氨蝶吟的给药方式存在颇多争议。本研究通过对比两种 不同的甲氨蝶吟给药方式联合米非司酮治疗异位妊娠的临床疗效和不良反应发 生率，取得满意效果。现报告如下： 1资料和方法 1.1 一般资料 选取本院产科2012年8月一2013年10月收治的异位妊娠患者80例，随机 分为A组和B组，每组40例。年龄26?35岁，平均(28.5plusmn;3.4)岁。 纳入标准：①所有患者通过临床表现结合血人绒毛膜促性腺激素(bet