Efficacy and safety of methotrexate intramuscular injection combined with mifepristone oral administration for ectopic pregnancy
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摘要:目的 探讨甲氨蝶呤肌注联合米非司酮口服治疗对异位妊娠的疗效及安全性。方法 选择42例异位妊娠患者作为研究对象，根据随机数表法将其分为对照组、观察组，各21例。对照组肌注甲氨蝶呤，观察组在对照组治疗基础上再口服米非司酮。观察并比较2组治疗后的效果，治疗前后的包块直径、血β-人绒毛膜促性腺激素(β-HCG), 住院、月经恢复、腹痛及包块消失时间，以及不良反应发生情况。结果 观察组总有效率为90.48%, 显著高于对照组的61.90%(P < 0.05)。治疗前, 2组的包块直径、血β-HCG值无显著差异(P>0.05); 治疗后，观察组的包块直径、血β-HCG值显著小于对照组(P < 0.05)。观察组的住院、月经恢复、腹痛及包块消失时间均显著短于对照组(P < 0.05)。观察组不良反应发生率略高于对照组，但差异无统计学意义(P>0.05)。结论 异位妊娠患者采用肌注甲氨蝶呤联合口服米非司酮治疗的效果显著，起效快，且安全性高。Abstract:Objective To study the efficacy and safety of methotrexate intramuscular injection combined with oral mifepristone oral administration in the treatment of ectopic pregnancy.Methods A total of 42 patients with ectopic pregnancy in our hospital were selected for the study. According to the random number table method, the patients were divided into control group and observation group, with 21 cases per group. The control group was given intramuscular injection of methotrexate, while the observation group was given mifepristone orally on the basis of the control group. The treatment efficacy, the diameter of mass, blood Blood β-human chorionic gonadotropin (β-HCG) value, hospital stay, menstrual recovery time, disappearance time of abdominal pain and mass, and adverse reactions were observed before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group (90.48% vs. 61.90%, P < 0.05). Before treatment, there were no significant differences in the diameter of mass and blood β-HCG between the two groups (P>0.05). After treatment, the above indicators in the observation group were significantly lower than that in the control group(P < 0.05). The hospital stay, menstrual recovery time, disappearance time of abdominal pain and mass were significantly shorter than that in the control group (P < 0.05). The incidence of adverse reactions in the observation group was slightly higher than that in the control group, but there was no significant difference between the two groups (P>0.05).Conclusion Methotrexate injection combined with oral mifepristone, characterized by quick onset and higher safety, has remarkable effect for patients with ectopic pregnancy.
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Keywords:
- ectopic pregnancy /
- methotrexate /
- mifepristone /
- efficacy /
- safety
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表 1 2组临床疗效比较[n(%)]
组别 n 痊愈 有效 无效 总有效 对照组 21 7(33.33) 6(28.57) 8(38.09) 13(61.90) 观察组 21 11(52.38) 8(38.10) 2(9.52) 19(90.48)* 与对照组比较, *P < 0.05。 
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表 2 2组治疗前后包块直径、血β-HCG值比较(x±s)
组别 n 包块直径/cm 血β-HCG值/(IU/L) 治疗前 治疗后 治疗前 治疗后 对照组 21 3.78±0.84 2.67±0.66* 1 714.26±197.58 1 323.68±144.07* 观察组 21 3.73±0.82 1.92±0.44*# 1 715.13±193.54 1 175.24±134.72*# 与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 3 2组住院、月经恢复、腹痛及包块消失时间(x±s)
d 组别 n 住院时间 月经恢复时间 腹痛消失时间 包块消失时间 对照组 21 15.68±1.97 31.67±5.94 8.46±1.23 14.25±2.01 观察组 21 13.52±1.91* 24.83±6.62* 6.23±1.35* 12.03±1.75* 与对照组比较, *P < 0.05。
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表 4 2组不良反应发生情况比较[n(%)]
组别 n 肝功能异常 白细胞减少 口腔溃疡 合计 对照组 21 1(4.76) 0 1(4.76) 2(9.52) 观察组 21 1(4.76) 1(4.76) 1(4.76) 3(14.28)
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[1] 何琳琳, 吴秀芬. 甲氨蝶呤单次与分次注射在异位妊娠保守治疗中的效果比较[J]. 实用临床医药杂志, 2017, 21(17): 168-169. doi: 10.7619/jcmp.201717058 [2] 周武. 甲氨蝶呤联合米非司酮治疗异位妊娠临床疗效及安全性研究[J]. 现代诊断与治疗, 2016, 27(22): 4245-4246. doi: 10.3969/j.issn.1001-8174.2016.22.028 [3] 刘莉娜, 武伟琦, 皇甫雨静. 甲氨蝶呤联合米非司酮治疗早期异位妊娠的临床疗效[J]. 保健医学研究与实践, 2017, 14(3): 49-51. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ201703013.htm [4] 李放. 甲氨蝶呤联合米非司酮治疗异位妊娠的疗效[J]. 中国医药导刊, 2017, 19(10): 1023-1025. doi: 10.3969/j.issn.1009-0959.2017.10.014 [5] 吕晓琳, 朱艳, 艾浩, 等. 甲氨蝶呤联合米非司酮治疗异位妊娠130例[J]. 中国生化药物杂志, 2015, 35(11): 76-77, 80. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYW201511023.htm [6] 张堃, 周鹏军, 吕向坤, 等. 甲氨蝶呤与米非司酮联合血府逐瘀胶囊治疗异位妊娠疗效及安全性分析[J]. 河北医药, 2016, 38(7): 1026-1028. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201607020.htm [7] 张媛艳, 陆勤. 米非司酮联合甲氨蝶呤和中药汤剂治疗异位妊娠的临床疗效与安全性分析[J]. 中国妇幼保健, 2016, 31(13): 2684-2686. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201613039.htm [8] 朱芸. 甲氨蝶呤联合米非司酮与单用甲氨蝶呤治疗异位妊娠的临床疗效比较[J]. 现代诊断与治疗, 2016, 27(7): 1228-1230. https://www.cnki.com.cn/Article/CJFDTOTAL-XDZD201607030.htm [9] 蒋永骊. 甲氨蝶呤联合米非司酮治疗异位妊娠临床疗效及安全性[J]. 中国继续医学教育, 2016, 8(20): 124-125. doi: 10.3969/j.issn.1674-9308.2016.20.082 [10] 代会波, 刘玉华. 探讨甲氨蝶呤联合米非司酮治疗异位妊娠的临床疗效及不良反应[J]. 中国妇幼保健, 2016, 31(17): 3570-3572. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201617054.htm [11] 卫素芬. 甲氨蝶呤联合米非司酮治疗异位妊娠的疗效及安全性分析[J]. 基层医学论坛, 2016, 20(32): 4488-4489. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201632010.htm [12] 祁彩珍. 甲氨蝶呤单次肌内注射与小剂量分次肌肉注射联合米非司酮保守治疗异位妊娠的疗效及安全性[J]. 临床医学研究与实践, 2018(10): 84-85. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS201810040.htm [13] 曹元秀. 甲氨蝶呤联合米非司酮改善异位妊娠生育需求患者内分泌功能及再次妊娠结局的作用[J]. 河北医药, 2018, 40(7): 994-998. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201807008.htm [14] 徐仲慧. 甲氨蝶呤合用米非司酮治疗异位妊娠18例的疗效观察[J]. 中国继续医学教育, 2018, 10(28): 133-135. doi: 10.3969/j.issn.1674-9308.2018.28.067 [15] 田甜. 甲氨蝶呤联合米非司酮治疗异位妊娠临床疗效及安全性评价[J]. 智慧健康, 2018(33): 83-84. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHJK201833041.htm [16] 李经华. 甲氨蝶呤联合米非司酮治疗异位妊娠的效果观察[J]. 中国民康医学, 2018, 30(21): 57-58. doi: 10.3969/j.issn.1672-0369.2018.21.025 [17] 金颖. 甲氨蝶呤联合米非司酮治疗异位妊娠的疗效观察[J]. 深圳中西医结合杂志, 2015, 25(7): 86-88. https://www.cnki.com.cn/Article/CJFDTOTAL-SZZX201507047.htm [18] 葛辉, 田秀萍. 甲氨蝶呤联合米非司酮治疗异位妊娠临床效果观察[J]. 黑龙江医学科学, 2015, 39(11): 1275-1276. https://www.cnki.com.cn/Article/CJFDTOTAL-DDYI200907026.htm [19] 陈小美. 异位妊娠应用甲氨蝶呤、米非司酮不同方案联合治疗的临床效果[J]. 北方药学, 2017, 14(4): 86-87. doi: 10.3969/j.issn.1672-8351.2017.04.076 [20] 张兴梅. 腹腔镜保守性手术配合甲氨蝶呤与米非司酮治疗异位妊娠的疗效探讨[J]. 中国医药指南, 2016, 14(17): 172-173. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201617144.htm [21] 王莉. 异位妊娠应用甲氨蝶呤联合米非司酮治疗的临床观察[J]. 中国医药指南, 2015, 13(1): 134-135. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201501098.htm
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