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1例36岁异位妊娠患者采用药物保守治疗。医嘱为米非司酮100 mg口服，1次/d，连续3 d；第4天甲氨蝶呤（MTX）80 mg入0.9%氯化钠注射液40 ml静脉泵入。第4天，当班护士未严格核对医嘱，误将规格为1 000 mg/瓶的MTX全部入0.9%氯化钠注射液40 ml并在30 min内静脉泵入。13 h后，患者出现恶心、呕吐、腹痛等症状。2 d后实验室检查示血清肌酐325 μmol/L，尿素氮8.6 mmol/L，尿酸501 μmol/L。考虑为急性肾衰竭，与MTX有关。患者转院并接受血液透析和对症治疗6 d后好转，12 d后复查：血清肌酐73 μmol/L，尿素氮4.1 mmol/L，尿酸363 μmol/L。“,”A 36-year-old female patient with ectopic pregnancy received conservative treatment with drugs. The doctor ordered oral mifepristone 100 mg once daily for 3 days and then a venous pumping of methotrexate (MTX) 80 mg dissolved in 0.9% sodium chloride injection 40 ml. On the 4th day, the nurse on duty did not strictly check the doctor′s orders. She mistakenly put a whole bottle of MTX (1 000 mg/bottle) into 0.9% sodium chloride injection 40 ml and pumped it intravenously within 30 minutes. Thirteen hours later, the patient developed nausea, vomiting, and abdominal pain. Two days later, the laboratory tests showed serum creatinine 325 μmol/L, urea nitrogen 8.6 mmol/L, and uric acid 501 μmol/L. Acute kidney failure was considered, which might be related to MTX. The patient was transferred to another hospital and got better after receiving hemodialysis and symptomatic treatments for 6 days. Twelve days later, the reexamination results showed serum creatinine 73 μmol/L, urea nitrogen 4.1 mmol/L, and uric acid 363 μmol/L.