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目的 :探讨单剂氨甲喋呤 (MTX)肌注治疗异位妊娠的适应症、临床效果及输卵管再畅和受孕情况。方法 :对 75例异位妊娠患者采用 MTX单剂肌注 (5 0 m g/ m2 ) ,不用四氢叶酸解毒方案治疗 ,定时监测血β- h CG直至正常 ,同时查血孕酮 ,B超检查异位妊娠包块直径大小及消失时间 ,治疗后作输卵管通液术或造影术。结果 :70例成功 ,成功率 93% ,成功与失患者孕龄、异位妊娠包块直径大小无显著差异性 ,与治疗前腹痛症状的发生率及血β- h CG值间的差异有显著性 ,输卵管再畅率 91.4% ,宫内妊娠率 11.4% ,再次异位妊娠率 1.4%。结论 :单剂氨甲喋呤治疗异位妊娠适用于无腹痛症状 ,异位妊娠包块直径≤ 3.5 cm、血β-h CG<5 0 0 0 Iu/ L的病列 ;此法输卵管再畅率较高 ,适用于需要保留生育能力的患者。
Objective: To investigate the indications of single-dose methotrexate (MTX) intramuscular injection in the treatment of ectopic pregnancy, clinical effects and tubal smoothing and pregnancy. Methods: A total of 75 patients with ectopic pregnancy were treated with MTX single intramuscular injection (50 mg / m2) without the treatment of tetrahydrofolate detoxification regimen. The blood levels of β-h CG were monitored regularly until normal, meanwhile progesterone and B ultrasound Ectopic pregnancy mass size and disappearance of time, after treatment for tubal fluid or angiography. Results: The success rate was 93% in 70 cases. There was no significant difference in the gestational age and ectopic pregnancy mass diameter between success and failure group. There was significant difference between the incidence of abdominal pain symptom before treatment and the blood β-h CG value Sex, tubal patency rate of 91.4%, intrauterine pregnancy rate of 11.4%, again ectopic pregnancy rate of 1.4%. CONCLUSIONS: A single-dose methotrexate treatment of ectopic pregnancy is suitable for patients with no symptoms of abdominal pain. Ectopic pregnancy has a diameter ≤ 3.5 cm and a blood β-h CG <50,000 Iu / L; , For patients who need to retain fertility.