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目的:探讨药物保守治疗宫颈妊娠的策略。方法:分别采用甲氨蝶呤单药化疗3例,以及甲氨蝶呤、放线菌素D与环磷酰胺联合化疗3例宫颈妊娠患者,治疗过程中监测血清HCG及B超,分析不同方案的用药指征及治疗效果。结果:6例患者治疗后血清HCG值下降明显,保守治疗均获得成功。结论:宫颈妊娠的治疗已趋向于保守,对于血清HCG值<10 000mU/ml患者可选用甲氨蝶呤单药化疗;对于血清HCG值≥10 000 mU/ml,胚胎见心管搏动,或甲氨蝶呤治疗失败的患者,采用联合化疗方案,可获得保守治疗成功。
Objective: To investigate the strategy of conservative treatment of cervical pregnancy. Methods: Three cases of methotrexate chemotherapy and three cases of cervical pregnancy were treated with methotrexate, actinomycin D and cyclophosphamide, respectively. Serum HCG and B-ultrasound were monitored during the treatment. Medication indications and treatment. Results: Serum HCG decreased significantly in 6 patients after treatment, and conservative treatment was successful. CONCLUSIONS: Treatment of cervical pregnancy has tended to be conservative and methotrexate monotherapy is recommended for patients with serum HCG values <10 000 mU / ml; for HCG values ≥ 10,000 mU / ml, embryo heart beats or A Patients treated with methotrexate failed to receive conservative treatment with a combination chemotherapy regimen.