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目的探讨宫外孕药物保守治疗的指征及方案。方法选取115例宫外孕住院患者,根据血β-人绒毛膜促性腺激素(β-HCG)浓度不同分3组,A组β-HCG≤5000 U/L予氨甲喋呤(MTX)+米非司酮;B组β-HCG 5000~8000 U/L及C组β-HCG>8000 U/L予MTX+米非司酮+5-氟尿嘧啶(5-FU)药物治疗,对其治疗效果及不良反应进行分析研究。结果①115例患者,成功107例,失败8例,总治愈率93.04%,无一例严重不良反应;②β-HCG≤5000 U/L96例,成功91例,成功率94.79%,β-HCG〉5000 U/L19例,成功16例,成功率84.21%,二者比较P<0.05,差异有统计学意义;③B组13例,成功12例,成功率92.31%;C组6例,成功4例,成功率66.67%,B、C组比较均P<0.05,差异有统计学意义,A、B组比较P>0.05,差异无统计学意义。结论本研究显示宫外孕药物保守治疗效果满意,其指征可适当放宽至β-HCG≤5 000 U/L,并应根据β-HCG值、B超检查等综合考虑选择不同药物治疗方案。
Objective To explore the indications and protocols of conservative treatment of ectopic pregnancy. Methods One hundred and fifteen patients with ectopic pregnancy were enrolled. Patients were divided into three groups according to the concentration of β-HCG, β-HCG≤5000 U / L methotrexate (MTX) + mifepristone in group A; The effect and side effects of MTX + mifepristone plus 5-fluorouracil (5-FU) on β-HCG 5000-8000 U / L in group B and β-HCG> 8000 U / L in group C . Results ① In 115 patients, 107 cases were successful and 8 cases failed. The total cure rate was 93.04%, without serious adverse reactions. ② In 96 cases with β-HCG ≤ 5000 U / L, the success rate was 94.79% and β-HCG> 5000 U / L19 cases, 16 cases were successful, the success rate was 84.21%, both P <0.05, the difference was statistically significant; ③ B group of 13 cases, 12 cases of success, the success rate was 92.31%; C group of 6 cases, 4 cases of success Rate of 66.67%, B, C group were P <0.05, the difference was statistically significant, A, B group P> 0.05, the difference was not statistically significant. Conclusion This study shows that conservative treatment of ectopic pregnancy with satisfactory results, the indications can be appropriately relaxed to β-HCG ≤ 5000 U / L, and should be based on the β-HCG value, B-ultrasound and other considerations to choose a different drug treatment options.