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目的探讨甲氨蝶呤(MTX)不同治疗方案对未破裂型输卵管妊娠的疗效。方法2001年1月至2004年4月吉林大学第二临床医院对164例未破裂型输卵管妊娠病例进行分析,随机分成Ⅰ、Ⅱ、Ⅲ、Ⅳ4组Ⅰ组采用MTX50mg/m2加液体隔日静脉滴注3次,及四氢叶酸(C.F)隔日肌注3次;Ⅱ组采用MTX50mg/m2单次分臀肌注;Ⅲ、Ⅳ组分别同Ⅰ、Ⅱ组方案的同时均加用米非司酮150mg口服。结果Ⅰ组成功率为73.17%(30/41);Ⅱ组成功率92.68%(38/41);Ⅲ组成功率为75.61%(31/41);Ⅳ组成功率为87.80%(36/41);Ⅰ、Ⅱ组间及Ⅲ、Ⅳ组间差异有显著性(P<0.01)Ⅰ、Ⅲ组间及Ⅱ、Ⅳ组间差异无显著性(P>0.05)。结论使用MTX50mg/m2单次肌注,较分次静脉滴注加C.F解救方案疗效好,而加用米非司酮方案并未增加疗效,相应地增加了药物的毒副反应。
Objective To investigate the effect of different methotrexate (MTX) treatment on unruptured tubal pregnancy. Methods From January 2001 to April 2004, 164 cases of unruptured tubal pregnancy were analyzed in the Second Clinical Hospital of Jilin University. Patients in group Ⅰ, Ⅱ, Ⅲ and Ⅳ were randomly divided into group Ⅰ (MTX50mg / m2 plus liquid every other day) 3 times, and intramuscular injection of tetrahydrofolate (CF) every other day for 3 times. In group Ⅱ, intramuscular injection of MTX50mg / m2 was given in one single dose. Group Ⅲ and Ⅳ were treated with mifepristone 150mg oral. Results The success rate of group Ⅰ was 73.17% (30/41); the success rate of group Ⅱ was 92.68% (38/41); the success rate of group Ⅲ was 75.61% (31/41); the success rate of group Ⅳ was 87.80% (36/41) There was significant difference between group Ⅱ and group Ⅲ, Ⅳ (P <0.01). There was no significant difference between group Ⅰ, Ⅲ and group Ⅱ, Ⅳ (P> 0.05). Conclusion MTX50mg / m2 single intramuscular injection, compared with fractional intravenous infusion plus C.F rescue effect is good, but with mifepristone did not increase the efficacy of the program, which increases the drug side effects.