CAJ | 학술논문

目的：比较甲氨蝶呤不同给药方式配伍米非司酮治疗异位妊娠的临床疗效。方法：按照数字随机分组法将180例早期异位妊娠患者均分为A、B、C 三组，A组患者给予MTX小剂量连续肌肉注射配伍米非司酮治疗，B组患者给予MTX单次肌肉注射配伍米非司酮治疗，C组给予经阴道超声引导下行异位妊娠囊穿刺注药杀胚术配合MTX一次性肌肉注射配伍米非司酮治疗，比较3组患者治疗后第4 d、7 d、10 d、14 d血β-HCG下降率、妊娠包块直径、临床疗效及不良反应发生率。结果：A组患者治疗成功率明显低于B、C两组，不良反应发生率明显高于B、C两组，差异具有显著性(P＜0.05)；B、C两组治疗成功率和不良反应发生率比较，差异无统计学意义(P＞0.05)；A组患者治疗后7d、10d、14d血β-HCG下降率明显低于B、C两组，差异具有显著性(P＜0.05)；B、C两组血β-HCG下降率比较，差异无统计学意义(P＞0.05)；三组患者治疗前、治疗后7 d及治疗后14 d异位妊娠包块直径比较，差异均无统计学意义(P＞0.05)。结论：MTX单次肌肉注射或经阴道超声引导下行异位妊娠囊穿刺注药杀胚术配合MTX一次性肌肉注射配伍米非司酮治疗异位妊娠临床疗效和血β-HCG改善情况更佳，不良反应发生率更低，但MTX单次肌肉注射操作更简单，临床应用和推广价值较高。
목적：비교갑안접령불동급약방식배오미비사동치료이위임신적림상료효。방법：안조수자수궤분조법장180례조기이위임신환자균분위A、B、C 삼조，A조환자급여MTX소제량련속기육주사배오미비사동치료，B조환자급여MTX단차기육주사배오미비사동치료，C조급여경음도초성인도하행이위임신낭천자주약살배술배합MTX일차성기육주사배오미비사동치료，비교3조환자치료후제4 d、7 d、10 d、14 d혈β-HCG하강솔、임신포괴직경、림상료효급불량반응발생솔。결과：A조환자치료성공솔명현저우B、C량조，불량반응발생솔명현고우B、C량조，차이구유현저성(P＜0.05)；B、C량조치료성공솔화불량반응발생솔비교，차이무통계학의의(P＞0.05)；A조환자치료후7d、10d、14d혈β-HCG하강솔명현저우B、C량조，차이구유현저성(P＜0.05)；B、C량조혈β-HCG하강솔비교，차이무통계학의의(P＞0.05)；삼조환자치료전、치료후7 d급치료후14 d이위임신포괴직경비교，차이균무통계학의의(P＞0.05)。결론：MTX단차기육주사혹경음도초성인도하행이위임신낭천자주약살배술배합MTX일차성기육주사배오미비사동치료이위임신림상료효화혈β-HCG개선정황경가，불량반응발생솔경저，단MTX단차기육주사조작경간단，림상응용화추엄개치교고。
Objective To compare the effect of MTX joint mifepristone on patients with ectopic pregnancy. Methods 180 cases of patients with ectopic pregnancy were randomly divided into three groups. Group A was treated by MTX consec-utive intramuscular combined with mifepristone, group B was treated by MTX single intramuscular combined with mifepri-stone, group C was treated by transvaginal ultrasound-guided ectopic pregnancy embryo sacs puncture note for injecting MTX combined with mifepristone. After treatment, the three groups of patients with bloodβ-HCG changes in the value, ec-topic pregnancy bag piece of diameter variation , clinical effects and the incidence of adverse reactions were compared. Results The treatment success rate was substantially below group B and group C, the incidence of adverse reactions was substantially above group B and group C, the difference was significant (P<0.05);The difference of the treatment success and the incidence of adverse reactions between the group B and group C had no statistical significance(P>0.05);The rate ofβ-HCG descend was substantially below group B and group C in 7d, 10d, 14d, the difference was significant(P<0.05);The rate ofβ-HCG descend between the group B and group C had no statistical significance(P>0.05);The ectopic pregnancy bag piece of diameter variation in prior treatment, posttreatment 7d and 14d between the three groups had no statistical significance(P>0.05). Con-clusion Single intramuscular methotrexate compatibility mifepristone and transvaginal ultrasound-guided ectopic preg-nancy embryo sacs puncture group have high cure rate of early ectopic pregnancy, the adverse reaction is small. Single in-tramuscular methotrexate compatibility mifepristone's require of simpler operation, it can be used for a wide range.