CAJ | 학술논문

目的：探讨米非司酮＋甲氨蝶呤对瘢痕妊娠的疗效及安全性。方法选择易县妇幼保健院和解放军总医院2008年1月至2012年12月收治的200例子宫切口瘢痕妊娠患者，随机将患者分为治疗组（ n＝100例）和对照组（ n＝100例）。对照组给予甲氨蝶呤50mg，阴道超声注入，2次／日，连续3天。治疗组在对照组基础上给予米非司酮50mg，口服，2次／日，连续3天。评定两组治疗1个月的疗效，记录其不良反应。结果治疗组治愈率为95．0％，高于对照组的71．0％（χ2＝10．235，P＜0．05）。治疗组包块消失时间、血β－人绒毛膜促性腺激素转阴时间均少于对照组（t值分别为8．772、8．993，均P＜0．05）。治疗组白细胞降低、肝酶升高、消化道炎症、口腔炎、发热的发生率均低于对照组（χ2值分别为8．553、9．005、7．885、8．647、9．541，均P＜0．05）。结论米非司酮＋甲氨蝶呤治疗子宫切口瘢痕妊娠的治愈率高，不良反应发生率低，治疗方法简单，值得推广使用。
목적：탐토미비사동＋갑안접령대반흔임신적료효급안전성。방법선택역현부유보건원화해방군총의원2008년1월지2012년12월수치적200례자궁절구반흔임신환자，수궤장환자분위치료조（ n＝100례）화대조조（ n＝100례）。대조조급여갑안접령50mg，음도초성주입，2차／일，련속3천。치료조재대조조기출상급여미비사동50mg，구복，2차／일，련속3천。평정량조치료1개월적료효，기록기불량반응。결과치료조치유솔위95．0％，고우대조조적71．0％（χ2＝10．235，P＜0．05）。치료조포괴소실시간、혈β－인융모막촉성선격소전음시간균소우대조조（t치분별위8．772、8．993，균P＜0．05）。치료조백세포강저、간매승고、소화도염증、구강염、발열적발생솔균저우대조조（χ2치분별위8．553、9．005、7．885、8．647、9．541，균P＜0．05）。결론미비사동＋갑안접령치료자궁절구반흔임신적치유솔고，불량반응발생솔저，치료방법간단，치득추엄사용。
Objective To explore the curative effect and safety of Mifepristone combined with Methotrexate on scar pregnancy .Methods Totally 200 patients with uterine incision scar pregnancy in Yixian Maternity and Child Care Center and General Hospital of the People ’ s Liberation Army between January 2008 and December 2012 were chosen in the study , and they were randomly divided into treatment group ( n=100) and control group ( n=100 ) .The control group was given Methotrexate , and the treatment group was additionally given oral Mifepristone based on the therapy for the control group .Methotrexate was given 50 mg for 3 days by vaginal ultrasound injection , twice per day.The curative effects of two groups after one month of treatment were assessed , and the adverse reactions were recorded .Results The cure rate of the treatment group was 95.0%, which was significantly higher than the control group of 71.0% (χ2 =10.235,P<0.05). The bag piece disappearing time and blood β-hCG turning negative time were significantly less in the treatment group than in the control group (t value was 8.772 and 8.993, respectively, both P <0.05).Compared with the control group , the incidence of blood cells reduce , liver enzymes elevation , digestive tract inflammation , oral inflammation , and fever was lower in the treatment group (χ2 value was 8.553, 9.005, 7.885, 8.647 and 9.541, respectively, all P<0.05).Conclusion Mifepristone combined with Methotrexate has high curative rate and low incidence of adverse reactions on scar pregnancy .The method is simple and can be used widely in clinics .