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目的探讨米非司酮联合甲氨蝶呤保守治疗异位妊娠的临床疗效。方法选取贵州天健七十三医院2013年3月—2015年4月收治的异位妊娠患者130例,按照随机数字表法分为对照组和治疗组,各65例。对照组患者采用注射用甲氨蝶呤治疗,治疗组患者在对照组基础上联合米非司酮,两组患者均持续治疗2周。比较两组患者的临床疗效、异位妊娠包块消失时间、β-人绒毛促性腺激素(β-HCG)恢复正常时间及不良反应发生情况。结果两组患者治疗总有效率比较,差异无统计学意义(P>0.05)。治疗组患者异位妊娠包块消失时间和β-HCG恢复正常时间短于对照组(P<0.05)。治疗组患者胃肠道不适发生率高于对照组(P<0.05);两组患者轻度转氨酶升高发生率比较,差异无统计学意义(P>0.05)。结论采用米非司酮联用甲氨蝶呤保守治疗早期异位妊娠的临床疗效好,可明显缩短患者包块消失时间和β-HCG恢复正常时间,改善异位妊娠症状,且安全性好。
Objective To investigate the clinical efficacy of conservative treatment of ectopic pregnancy with mifepristone and methotrexate. Methods 130 cases of ectopic pregnancy treated by Tianjian Seventy-three Hospital of Guizhou from March 2013 to April 2015 were divided into control group and treatment group according to random number table method, and each group had 65 cases. Patients in the control group were treated with methotrexate for injection. Patients in the treatment group were treated with mifepristone on the basis of the control group, and both groups were treated for 2 weeks. The clinical efficacy, the disappearance of ectopic pregnancy mass, the recovery time of β-HCG and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of the two groups of patients was no significant difference (P> 0.05). The disappearance time of ectopic pregnancy and the recovery time of β-HCG in treatment group were shorter than those in control group (P <0.05). The incidence of gastrointestinal discomfort in the treatment group was higher than that in the control group (P <0.05). There was no significant difference between the two groups in the incidence of mild aminotransferase (P> 0.05). Conclusion Good clinical efficacy of mifepristone in the treatment of early ectopic pregnancy with methotrexate conservative and can significantly shorten the time patients mass disappeared and β-HCG recovery time, improve the symptoms of ectopic pregnancy, and good security.