米非司酮与甲氨蝶呤治疗异位妊娠的比较(1)
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[摘要] 目的：探讨米非司酮加中药及甲氨蝶呤(MTX)加中药两种方法保守治疗异位妊娠的效果。方法：回顾分析我院2000年12月～2010年12月间80例异位妊娠患者资料，随机分成观察组(采用米非司酮治疗)42例和对照组(采用甲氨蝶呤治疗)38例，对两组的治疗效果及各项指标进行对比。结果：观察组治愈率为76.19%，对照组治愈率为78.95%。两组治愈率、血β-HCG转阴时间、包块消失时间比较，差异均无统计学意义(P>0.05)，但对照组组副反应较重，差异有统计学意义(P<0.01)。结论：米非司酮、甲氨蝶呤联合中药保守治疗异位妊娠有效且安全，但应用米非司酮治疗不良反应更小。
[关键词] 异位妊娠；米非司酮；甲氨蝶呤；保守治疗
[中图分类号] R714.22[文献标识码]A [文章编号]1673-7210(2011)07(c)-073-02
The comparison of ectopic pregnancy treated with Mifepristone and Methopterin
WANG Aixiang
Dpartment of Gynaecology and Obstetrics, the First Hospital of Anyang City, He′nan Province, Anyang 455000, China
[Abstract] Objective: To explore the effect of Mifepristone adding the traditional Chinese medicine and Methotrexate adding traditional Chinese medicine in expectant treatment of ectopic pregnancy. Methods: The clinical data of 80 patients with ectopic pregnancy were analyzed retrospectively. All patients were randomly divided into observation group (treated with Mifepristone) and control group(treated with Methotrexate), the treatment effect and each index were compared. Results: The recovery rate of observation group was 76.19%, and 78.95% in control group. The recovery rate and the darkening time of blood β-HCG and the extinction time of block of two groups had no statistical difference (P>0.05). But the adverse reaction of control group was severe (P<0.01). Conclusion: The expectant treatment of ectopic pregnancy with Mifepristone and Methotrexate adding the traditional Chinese medicine is effective and safe, but the adverse reaction of Mifepristone group is less.
[Key words] Ectopic pregnancy; Mifepristone; Methotrexate; Expectant treatment
近年来，由于阴道超声和快速敏感β-HCG的应用，使异位妊娠能得到早期治疗，为保守治疗提供了时机。我院分别用米非司酮+中药及甲氨蝶呤(MTX)+中药两种方法治疗异位妊娠，现报道如下：
1 资料与方法
1.1 一般资料
选择2000年12月～2010年12月入院确诊为异位妊娠，采用保守治疗的患者80例，其中，给予米非司酮治疗42例(观察组)，年龄19～36岁，平均(24.0±5.1)岁，甲氨蝶呤治疗者38例(对照组)，年龄20～37岁，平均(25±4.2)岁。保守治疗条件：患者生命体征平稳，无腹腔急性内出血的体征；B超证实宫腔内无妊娠囊、附件区异位妊娠包块最大直径≤5 cm；肝肾功能正常，外周血白细胞4×109/L。
1.2 方法
观察组：每日早晚空腹口服米非司酮50 mg，共3 d。酌情给予第2或第3疗程的治疗。对照组：采用甲氨蝶呤全身给药法。单次50 mg/m2，臀位肌注，不使用甲酰四氢叶酸解毒。酌情给予第2或第3疗程的治疗 ......
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