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目的探讨甲氨蝶呤联合米非司酮治疗早期异位妊娠的疗效及安全性。方法选取早期异位妊娠患者97例,按照随机数字表法分为观察组49例,对照组48例。对照组:甲氨蝶呤50 mg静脉推注1次/d,连用5 d,次日用甲酰四氢叶酸钙6 mg肌内注射解毒。观察组:甲氨蝶呤20 mg静脉推注1次/d,连用5 d;米非司酮50 mg,空腹口服,每12 h用1次,连用6次,总量300 mg。结果观察组治愈43例,对照组治愈34例,观察组优于对照组,有显著性差异(P<0.05)。两组治疗后血β-HCG及盆腔包块体积均较治疗前降低,观察组降低幅度优于对照组(P<0.05)。治疗后观察组血β-HCG及盆腔包块体积均优于对照组,差异有统计学意义(P<0.05)。组间不良反应发生率比较无显著性差异(P>0.05)。结论联合应用甲氨蝶呤与米非司酮对于早期未破裂异位妊娠疗效显著,不良反应发生率低,适宜基层医疗单位推广应用。
Objective To investigate the efficacy and safety of methotrexate combined with mifepristone in the treatment of early ectopic pregnancy. Methods 97 cases of early ectopic pregnancy were selected and divided into observation group (49 cases) and control group (48 cases) by random number table. Control group: methotrexate 50 mg intravenously once a day for 5 d, the next day with leucovorin 6 mg intramuscular injection detoxification. Observation group: methotrexate 20 mg intravenously once a day for 5 days; mifepristone 50 mg, fasting oral once every 12 hours for 6 times, the total amount of 300 mg. Results The observation group was cured in 43 cases, the control group cured 34 cases, the observation group was superior to the control group, there was a significant difference (P <0.05). The blood volume of β-HCG and pelvic mass in both groups after treatment were lower than those before treatment, and the decrease in observation group was better than that in control group (P <0.05). After treatment, the blood β-HCG and the volume of pelvic mass in the observation group were better than those in the control group, with significant difference (P <0.05). The incidence of adverse reactions between the two groups showed no significant difference (P> 0.05). Conclusions The combination of methotrexate and mifepristone has a significant effect on early unruptured ectopic pregnancy with a low incidence of adverse reactions and is suitable for the promotion and application of primary medical units.