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目的:探讨氨甲喋呤(MTX)联合米非司酮(Ru 486)及单用MTX注射保守治疗异位妊娠的疗效比较。方法:对256例患者行血绒毛促性腺激素(β-HCG)测定和B超检查,确诊异位妊娠后,应用随机分类法分为2组,A组119例采用MTX 50 mg/m2单次肌注并加服Ru 486 150 mg,MTX剂量≤80 mg/次;B组137例单用MTX治疗。用药5天后两组若血β-HCG下降<15%,可再次用药。结果:A组成功率88.23%(105/119),B组86.13%(118/137),两组比较,差异无显著性(P>0.05)。第一疗程成功率,A组71.42%(85/119),B组56.20%(77/137),两组比较差异有显著性(P<0.05)。MTX剂量:A组平均93.33 mg,B组113.37 mg,两组比较差异有显著性(P<0.05)。平均住院日:A组(9.1±3.6)天,B组(13.48±5.2)天,两组比较差异有高度显著性(P<0.01)。结论:MTX与Ru 486联合治疗异位妊娠效果确切,剂量小,疗程短,副反应较微,是一种较理想的治疗方法。
Objective: To investigate the efficacy of methotrexate (MTX) in combination with mifepristone (Ru 486) and MTX alone in conservative treatment of ectopic pregnancy. Methods: 256 cases of patients with blood chorionic gonadotropin (β-HCG) determination and B-ultrasound, diagnosis of ectopic pregnancy, randomized classification is divided into two groups, 119 cases of group A MTX 50 mg / m2 single Intramuscular injection plus Ru 486 150 mg, MTX dose ≤ 80 mg / time; Group B 137 cases with MTX alone. After 5 days of treatment if blood β-HCG decreased <15%, can be used again. Results: The success rate of group A was 88.23% (105/119) and group B was 86.13% (118/137). There was no significant difference between the two groups (P> 0.05). The success rate of the first course of treatment was 71.42% (85/119) in group A and 56.20% (77/137) in group B, with significant difference between the two groups (P <0.05). MTX dose: A group average 93.33 mg, B group 113.37 mg, the difference between the two groups was significant (P <0.05). The average length of hospital stay was 9.1 ± 3.6 days in group A and 13.48 ± 5.2 days in group B, respectively. There was a significant difference between the two groups (P <0.01). CONCLUSION: The combination of MTX and Ru 486 in treating ectopic pregnancy has definite effect, small dosage, short course of treatment and minor side effects. It is an ideal treatment method.