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目的观察中药联合米非司酮和甲氨蝶呤(MTX)治疗剖宫产后子宫切口妊娠的疗效。方法选择2005年1月至2006年10月间住院的剖宫产术后子宫切口部位早期妊娠患者64例,随机分为A、B两组,每组32例,A组用米非司酮50mg,每12小时1次,连用5d,静脉滴注MTX20mg/d,连用5d,中药(生化汤)1剂/d,连用5d。B组联用米非司酮和MTX,剂量同A组,每周测定血β-HCG判断治疗效果。结果A组治疗成功率为93.8%,B组成功率为81.2%(P<0.05);A组患者血β-HCG下降到正常时间及附件区包块消失时间均较B组短(P<0.05);A组出现恶心呕吐、肝功能损害、血WBC下降例数均较B组少(P<0.05)。结论中药联合米非司酮和甲氨蝶呤(MTX)治疗剖宫产后子宫切口妊娠治愈率高、HCG下降快、附件区包块消失时间及住院时间短,不良反应发生少。
Objective To observe the efficacy of traditional Chinese medicine combined with mifepristone and methotrexate (MTX) in the treatment of uterine incision pregnancy after cesarean section. Methods 64 cases of early pregnancy after uterine incision in cesarean section hospitalized from January 2005 to October 2006 were randomly divided into A and B groups, 32 cases in each group. A group was treated with mifepristone 50mg , Once every 12 hours, once every 5 days, intravenous infusion of MTX 20mg / d, once every 5 days, Chinese medicine (biochemical soup) 1 dose / d, once every 5 days. B group with mifepristone and MTX, the same dose with the A group, weekly determination of serum β-HCG to determine the treatment effect. Results The success rate of treatment in group A was 93.8%, and that in group B was 81.2% (P <0.05). The time of serum β-HCG declining to normal in group A and the disappearance of mass in adjunct area were shorter than those in group B (P <0.05) In group A, nausea and vomiting, hepatic impairment and decrease of blood WBC were all less than those in group B (P <0.05). Conclusion Chinese medicine combined with mifepristone and methotrexate (MTX) in the treatment of uterine incision pregnancy after cesarean section, high cure rate, HCG decreased rapidly, disappearance of appendages block mass and hospitalization time, adverse reactions occur less.