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目的探讨甲氨蝶呤联合米非司酮治疗异位妊娠的临床效果。方法选择2007年1月—2011年12月收治的异位妊娠患者76例,随机分为对照组和观察组各38例。对照组采用甲氨蝶呤50 mg肌内注射,每2天1次,持续使用3-4次。观察组先口服米非司酮100 mg,每天1次,共服用3 d,联合使用甲氨蝶呤,用法与用量同对照组。治疗后两周比较两组治疗效果和不良反应。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果对照组总有效率68.42%,观察组总有效率94.74%,两组比较差异有统计学意义(χ2=8.756,P<0.05)。对照组无效12例,其中,血人绒毛膜促性腺激素(human chori-onic gonadotrophin,HCG)过高4例,腹痛加剧转手术治疗2例。观察组无效2例,其中,血HCG过高1例,腹痛加剧转手术治疗1例。对照组恶心4例,呕吐3例,口腔溃疡1例,共占21.05%;观察组恶心1例,呕吐1例,共占5.26%。两组比较差异有统计学意义(χ2=4.146,P<0.05)。结论甲氨蝶呤联合米非司酮治疗异位妊娠比单用效果好,不良反应小,值得推广。
Objective To investigate the clinical effect of methotrexate combined with mifepristone in the treatment of ectopic pregnancy. Methods 76 patients with ectopic pregnancy admitted from January 2007 to December 2011 were randomly divided into control group and observation group of 38 cases. Control group with methotrexate 50 mg intramuscular injection, once every 2 days, continued to use 3-4 times. Observation group first oral mifepristone 100 mg, 1 day, taking a total of 3 d, combined use of methotrexate, usage and dosage with the control group. Two weeks after treatment, the treatment effect and adverse reactions were compared between the two groups. Count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate of the control group was 68.42%, and the total effective rate of the observation group was 94.74%. The difference between the two groups was statistically significant (χ2 = 8.756, P <0.05). The control group was ineffective in 12 cases. Among them, 4 cases of HCG were over high and 2 cases were treated by abdominal pain. Observation group invalid 2 cases, of which 1 case of hypercholesterolemia, abdominal pain aggravated surgery in 1 case. Control group nausea in 4 cases, vomiting in 3 cases, oral ulcer in 1 case, accounting for a total of 21.05%; observation group nausea in 1 case, vomiting in 1 case, a total of 5.26%. The difference between the two groups was statistically significant (χ2 = 4.146, P <0.05). Conclusion Methotrexate combined with mifepristone treatment of ectopic pregnancy better than single effect, adverse reactions, it is worth promoting.