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目的探讨米非司酮联合不同剂量甲氨蝶呤治疗异位妊娠的临床疗效及其安全性。方法选取田林县人民医院2014年1月—2017年1月收治的异位妊娠患者60例,按照随机数字表法分为对照组和观察组,各30例。患者均给予米非司酮治疗,对照组患者给予甲氨蝶呤多次肌肉注射;观察组患者给予甲氨蝶呤单次肌肉注射。比较两组患者治疗前及治疗后第4、7、14、21天人绒毛膜促性腺激素(β-HCG)水平改善情况、临床疗效及药物不良反应发生情况。结果治疗前及治疗后第4、7、14、21天,两组患者β-HCG水平比较,差异无统计学意义(P>0.05)。两组患者治疗总有效率比较,差异无统计学意义(P>0.05)。观察组患者胃肠道反应发生率、血细胞计数减少发生率低于对照组(P<0.05)。结论米非司酮联合甲氨蝶呤治疗异位妊娠临床疗效确切,而甲氨蝶呤单次注射可有效降低不良反应发生率,安全性好。
Objective To investigate the clinical efficacy and safety of mifepristone combined with different doses of methotrexate in the treatment of ectopic pregnancy. Methods Sixty patients with ectopic pregnancy admitted from January 2014 to January 2017 in Tianlin County People’s Hospital were randomly divided into control group and observation group according to the random number table method, with 30 cases in each group. Patients were given mifepristone treatment, patients in the control group were given methotrexate multiple intramuscular injection; the observation group were given a single intramuscular injection of methotrexate. The improvement of human chorionic gonadotropin (β-HCG) levels, clinical efficacy and adverse drug reactions on the 4th, 7th, 14th and 21st day before and after treatment were compared between the two groups. Results Before treatment and on the 4th, 7th, 14th and 21st days after treatment, there was no significant difference in β-HCG levels between the two groups (P> 0.05). There was no significant difference in the total effective rate between the two groups (P> 0.05). The incidence of gastrointestinal reaction and reduction of blood count in the observation group was lower than that in the control group (P <0.05). Conclusion The combination of mifepristone and methotrexate is effective in the treatment of ectopic pregnancy, and the single injection of methotrexate can effectively reduce the incidence of adverse reactions and has good safety.