中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
9期
56-57
,共2页
异位妊娠%MTX%米非司酮
異位妊娠%MTX%米非司酮
이위임신%MTX%미비사동
Eetopic Pregnancy%MTX%Mifepristone
目的 探讨影响MTX、米非司酮治疗异位妊娠疗效的相关因素.方法 确诊输卵管妊娠147例,月经周期规则,年龄21~42岁,停经时间31~68 d,血β-HCG<3000 U/L.单次静脉注射MTX75mg,同时口服米非司酮50 mg,每日两次,连续3 d.监测治疗过程中血β-HCG、附件包块大小临床症状.结果 147例患者接受治疗,成功率79.59%,其中在停经50 d内,疗效显著,停经超过60 d者疗效最差,P<0.01;在血β-HCG<2000 U/L中,成功率分别为91.89%、83.33%,其疗效无显著性差异P>0.05,血β-HCG2000~3000 U/L的病例,其疗效明显下降,与前两组比较,差异有显著性P<0.01;治疗48 h血β-HCG下降速度>30%者,疗效最佳,与下降10~30%者,差异有显著性,P<0.05,下降<10%者,疗效最差,与前两组比较,差异显著P<0.01;不同输卵管妊娠包块最大直径其疗效差异无显著性P>0.05.结论 MTX、米非司酮治疗异位妊娠成功率为79.59%,停经时间、血β-HCG值及其下降程度是影响疗效的主要因素,不同输卵管妊娠包块大小对疗效的影响不明显.
目的 探討影響MTX、米非司酮治療異位妊娠療效的相關因素.方法 確診輸卵管妊娠147例,月經週期規則,年齡21~42歲,停經時間31~68 d,血β-HCG<3000 U/L.單次靜脈註射MTX75mg,同時口服米非司酮50 mg,每日兩次,連續3 d.鑑測治療過程中血β-HCG、附件包塊大小臨床癥狀.結果 147例患者接受治療,成功率79.59%,其中在停經50 d內,療效顯著,停經超過60 d者療效最差,P<0.01;在血β-HCG<2000 U/L中,成功率分彆為91.89%、83.33%,其療效無顯著性差異P>0.05,血β-HCG2000~3000 U/L的病例,其療效明顯下降,與前兩組比較,差異有顯著性P<0.01;治療48 h血β-HCG下降速度>30%者,療效最佳,與下降10~30%者,差異有顯著性,P<0.05,下降<10%者,療效最差,與前兩組比較,差異顯著P<0.01;不同輸卵管妊娠包塊最大直徑其療效差異無顯著性P>0.05.結論 MTX、米非司酮治療異位妊娠成功率為79.59%,停經時間、血β-HCG值及其下降程度是影響療效的主要因素,不同輸卵管妊娠包塊大小對療效的影響不明顯.
목적 탐토영향MTX、미비사동치료이위임신료효적상관인소.방법 학진수란관임신147례,월경주기규칙,년령21~42세,정경시간31~68 d,혈β-HCG<3000 U/L.단차정맥주사MTX75mg,동시구복미비사동50 mg,매일량차,련속3 d.감측치료과정중혈β-HCG、부건포괴대소림상증상.결과 147례환자접수치료,성공솔79.59%,기중재정경50 d내,료효현저,정경초과60 d자료효최차,P<0.01;재혈β-HCG<2000 U/L중,성공솔분별위91.89%、83.33%,기료효무현저성차이P>0.05,혈β-HCG2000~3000 U/L적병례,기료효명현하강,여전량조비교,차이유현저성P<0.01;치료48 h혈β-HCG하강속도>30%자,료효최가,여하강10~30%자,차이유현저성,P<0.05,하강<10%자,료효최차,여전량조비교,차이현저P<0.01;불동수란관임신포괴최대직경기료효차이무현저성P>0.05.결론 MTX、미비사동치료이위임신성공솔위79.59%,정경시간、혈β-HCG치급기하강정도시영향료효적주요인소,불동수란관임신포괴대소대료효적영향불명현.
Objective Explore the effects of MTX,efficacy of mifepristone treatment of ectopic pregnancy of the relevant factors.Methods Confirmed 147 cases of tubal pregnancy,the rules of the menstrual cycle,aged 21-42 years old,stopped by the time 31-68 days,blood β-HCG < 3000u / L.Single intravenous injection MTX75 nag,while oral mifepristone 50 mg,twice daily,for 3 consecutive days.The process of monitoring the treatment of blood β-HCG,Annex mass the size of the clinical symptoms.Results 147 cases of patients receiving treatment,the success rate of 79.59%,of which 50 days in the menopause,the effect of significant menopause more than 60 days from the worst effects,P <0.01 ;in blood β-HCG <2000 u / L,the success rates for 91.89%,83.33%,and its efficacy was no significant difference P>0.05,plasma β-HCG2000~3000 u / L cases,its efficacy decreased compared with the previous two groups,there was a significant difference P <0.01 ;treatment 48-hour blood velocity decreased β-HCG > 30%,the efficacy of the best,with 10~30% decline,and there was a significant difference,P <0.05,decrease <10%,the efficacy of the worst,with the former two groups,significant difference P<0.01;different tubal pregnancy maximum diameter of the mass effect of the difference was not significant P>0.05.Conclusion MTX,mifepristone treatment of ectopic pregnancy success rate of 79.59 percent,stopped by the time value of serum β-HCG and its decline in the extent of the main factors affect the efficacy of different size of tubal pregnancy mass effect was not obvious.