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目的探讨氨甲喋呤（MTX）单次静脉注射治疗异位妊娠的效果和适应证。方法对63例患者随机分成A、B两组。A组31例采用MTX100mg加生理盐水20ml静注，不用甲酸四氢叶酸（CF）解毒。B组32例应用同剂量MTX后12～24小时内用CF10～12mp解毒。定期测血p－hCG直至正常。结果两组中各有26例（89．66％，81．25％）获得成功。两组在成功率、患者年龄、孕龄、治疗前血β-hCG值和异位妊娠包块直径间的差异无显著性（P＞0．05）。结论早期诊断和严格选择应用对象是成功的关键。无急性内出血，异位妊娠包块直径≤5cm,血β-hCG＜5000IU/L，肝、肾和凝血功能正常是MTX治疗的适应证。
Objective To investigate the efficacy and indications of single intravenous methotrexate (MTX) in the treatment of ectopic pregnancy. Methods 63 patients were randomly divided into A and B groups. A group of 31 patients with MTX100mg intravenous injection of 20ml saline, without tetrahydrofolate (CF) detoxification. B group 32 patients with the same dose of MTX after 12 ~ 24 hours with CF10 ~ 12mp detoxification. Regular blood test p-hCG until normal. Results 26 cases (89.66%, 81.25%) were successful in both groups. There was no significant difference between the two groups in the success rate, patient’s age, gestational age, pre-treatment blood β-hCG value and ectopic pregnancy mass diameter (P> 0.05). Conclusion Early diagnosis and strict selection of the application of the object is the key to success. No acute internal bleeding, ectopic pregnancy mass diameter ≤ 5cm, blood β-hCG <5000IU / L, liver, kidney and coagulation is normal indications for the treatment of MTX.