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目的:探讨采用不同药物保守治疗异位妊娠的临床效果及安全性。方法:选择82例异位妊娠患者,根据所用药物不同分为A组(甲氨蝶呤,20例),B组(甲氨蝶呤+亚叶酸钙,48例),C组(米非司酮+中药,14例),治疗过程中观察并记录用药过程中外周血中β-HCG的浓度,肝肾功能以及阴道不规则流血的改善情况,同时记录用药不良反应的发生情况。结果:经保守治疗总有效例数为78例,总有效率为95.12%,其中A组患者中有效例数19例(95.00%),B组患者有效例数47例(97.92%),C组患者中有效例数12例(85.71%)。经统计检验,三组组间比较治疗有效率无明显差异(P>0.05)。A组患者中共发生5例消化道不良反应(25.00%);B、C两组患者的用药过程中未见明显不良反应发生。所有患者均未查见骨髓抑制情况。结论:药物治疗异位妊娠能获得较好疗效,特别适用于早期未破裂异位妊娠且有强烈生育愿望者,但选择药物保守治疗的指针以及方案等需慎重。
Objective: To investigate the clinical effect and safety of conservative treatment of ectopic pregnancy with different drugs. Methods: 82 cases of ectopic pregnancy were selected and divided into group A (methotrexate, 20 cases), group B (methotrexate + leucovorin, 48 cases), group C Ketone + traditional Chinese medicine, 14 cases). During the course of treatment, the concentration of β-HCG, hepatic and renal function and vaginal irregular blood flow were observed and recorded during treatment. At the same time, the occurrence of adverse drug reactions was recorded. Results: The total effective rate of conservative treatment was 78 cases, the total effective rate was 95.12%, of which 19 cases (95.00%) were effective in group A, 47 cases (97.92%) in group B, The number of effective cases in patients with 12 cases (85.71%). After statistical test, there was no significant difference between the three groups in the treatment efficiency (P> 0.05). A group of patients occurred in 5 cases of gastrointestinal adverse reactions (25.00%); B, C two groups of patients with medication during the course of no significant adverse reactions. All patients did not see myelosuppression. Conclusion: The drug treatment of ectopic pregnancy can get better curative effect, especially for early unruptured ectopic pregnancy and have a strong desire for childbearing, but the choice of guidelines and programs for conservative treatment need careful.