米非司酮联合甲氨蝶呤治疗不同血β-HCG 浓度宫外孕的疗效观察

【摘要】 目的 探讨米非司酮联合甲氨蝶呤在治疗不同血β-人绒毛膜促性腺激素(β-HCT)值的宫外孕的疗效。方法 选取321例宫外孕住院患者，所有患者给予米非司酮联合甲氨蝶呤治疗。根据血β-HCG 浓度不同分组，β-HCG≤1000U/L为A组，1000U/L＜β-HCG≤2000U/L为B组。β-HCG＞2000U/L为C组，统计各组患者的治愈率，比较各组的差异。结果 321例患者，成功246例，总治愈率为76.6%。其中，A组56例，成功47例，治愈率为83.9%；B组176例，成功139例，治愈率为79.0%，C组89例，成功60例，治愈率为67.4%；A组与C组、B组与C组治愈率比较，差异有统计学意义。A组与B组治疗率比较，差异无统计学意义(P>0.05)。结论 米非司酮联合甲氨蝶呤治疗宫外孕疗效显著，在β-HCG ≤2000 U/L 时，效果更加明显。

【关键词】 米非司酮；甲氨蝶呤；β-HCG；宫外孕

Observation of curative effect on Mifepristone combined with Methotrexate in the treatment of patients with ectopic pregnancy in different concentration of blood β-HCG LIU Shu-peng， YAO Hong, GENG Ying.Department of Gynecology,The Poeple’s Hospital of Changji,Xinjiang 831100,China

【Abstract】 Objective To observe the efficacy of Mifepristone combined with Methotrexate in the treatment of patients with ectopic pregnancy in different concentration of blood β-human chorionic gonadotropin (β-HCG). Methods 321 hospitalized patients with ectopic pregnancy were choose and all patients were taken oral Mifepristone combined with Methotrexate. According to different concentration of blood β-HCG, β-HCG≤1000U/L was group A, β-HCG＞1000U/L and ≤2000U/L was group B, β-HCG＞2000U/L was group C, the treatment effect and adverse reactions were summarized and the differences among all groups were compared. Results In 321 cases, 246 cases were healed, the total cure rate was 76.6%. In 56 cases of group A, 47 cases were healed, the cure rate was 83.9%.In 176 cases of group B, 139 cases were healed, the cure rate was 79.0%.in 89 cases of group C, 60 cases were healed, the cure rate was 67.4%.There was no significant difference between the group A and group B(P>0.05).There was significant difference between the group A and group C or the group B and group C (P

【Key words】 Mifepristone; Methotrexate; β-HCG; Ectopic pregnancy

由于妇科炎症发病率的升高,宫外孕的发病率也随之增高。宫外孕发病率占妊娠总数的2％，其中输卵管妊娠最常见，占异位妊娠95％左右。近年来，国内外宫外孕的发病率均呈上升趋势［1］。但随着血β-HCG值测定的敏感性提高,高分辨率阴道超声检查的普遍应用，使宫外孕能够得以早期确诊，早期治疗。从而降低了子宫外孕破裂内出血死亡和手术治疗的发生率降低，为保守治疗创造了有利条件。宫外孕保守治疗已成为有生育要求宫外孕患者治疗的主要手段。现将我院妇科2000年1月1日至2011年12月31日米非司酮(Mifepristone)联合甲氨蝶呤(Methotrexate)治疗未破裂型宫外孕321例的疗效观察分析如下。

1 资料与方法

1.1 一般资料

2000年1月1日至2011年12月31日我院住院的宫外孕患者，患者心肺肝肾功能正常未合并其他慢性疾病，无药物禁忌证，腹腔内无明显出血。患者年龄21～39岁(平均27.4岁)；停经35～62 d(平均43.4 d)；B超示附件区混合性包块1.6～4.2 cm(平均3.1 cm)，盆腔内无积液或有少量积液；将所有患者随机分组，各组患者在年龄、停经时间、包块大小及异位妊娠部位方面比较，差异均无统计学意义(P>0.05)，具有可比性。