黎梅

[摘要] 目的 分析甲氨蝶呤联合米非司酮治疗宫颈妊娠的临床疗效。方法 随机选取自2015年3月—2016年12月在该院就诊的宫颈妊娠患者其中的80例，随机分为对照组（甲氨蝶呤药物治疗）和观察组（甲氨蝶呤联合米非司酮药物治疗），组数均为40例，观察用药前后患者包块大小、阴道流血量、血β-HCG水平变化情况，统计治疗期間用药所致不良反应，对比观察两组的治疗效果。结果 甲氨蝶呤联合米非司酮的治疗有效率是82.5%，高于单纯使用甲氨蝶呤治疗的有效率50.0%，观察组的治疗率更高，结果差异有统计学意义（P<0.05）；治疗后观察组组血β-HCG、阴道流血量、宫颈包块，依次为（319.5±16.2）U/L、（23.2±14.8）mL、（5.5±1.6）cm3，与对照组为（809.4±60.1）U/L、（82.8±15.6）mL、（5.7±1.5）cm3比较，观察组β-HCG值、阴道流血量较对照组明显减少，差异有统计学意义（P<0.05）；两组宫颈包块的大小均无明显改善，差异无统计学意义（P>0.05）。结论 甲氨蝶呤在米非司酮药物的辅助下治疗宫颈妊娠，能有效提高宫颈妊娠的治疗率，减轻患者的临床不适症状，且对身体其他脏器副作用少，值得在临床推广使用。

[关键词] 宫颈妊娠；甲氨蝶呤；米非司酮

[中图分类号] R714 [文献标识码] A [文章编号] 1674-0742（2017）05（a）-0150-03

[Abstract] Objective To analyze the clinical effect of Methotrexate and Mifepristone in the treatment of cervical pregnancy. Methods Random selection 80 patients with cervical pregnancy treated from March 2015 to December 2016 in our hospital were selected. The changes of the size of the mass， the amount of vaginal bleeding and the level of serum -HCG were observed before and after treatment. The clinical effect for two groups was observed. Results The effective rate for observation group（82.5%） was significantly higher than control group （50.0%），the difference was statistically significant （P<0.05）；after treatment， the β-HCG value ， Vaginal bleeding， cervical mass for observation group（319.5±16.2）U/L，（23.2±14.8）mL、（5.5±1.6）cm3 was even lower than control group（809.4±60.1）U/L、（82.8±15.6）mL、（5.7±1.5）cm3； the vaginal bleeding volume for observation group was lower than control group，the difference was statistically significant（P<0.05）. After treatment， the size of cervical masses for two groups was not significantly different （P>0.05）.Conclusion For patients with cervical pregnancy， the combined therapy of Methotrexate and Mifepristone can improve the clinical effect， relieve the discomforts and reduce the adverse reactions for other organs. It is worthy of clinical promotion and application.

[Key words] cervical pregnancy； Methotrexate； Mifepristone

宫颈妊娠[1]是指受精卵未正常着床于子宫，在宫颈管内着床和发育的一种异位妊娠，其发病率低，但有逐年增长趋势，且发病急，为重症之一，故近年来愈加受到重视。传统的治疗方法多为刮宫术，在治疗中无法保留患者子宫时行子宫切除术[2]。随着医疗技术的不断发展，药物治疗成为最大程度保留患者生育能力的新选择，故对宫颈妊娠的治疗和诊断逐步趋向保守治疗。因此该院观察2015年3月—2016年12月期间40例宫颈妊娠者以甲氨蝶呤、米非司酮联合治疗的效果，现报道如下。

1 资料与方法

1.1 一般资料

随机选取于该院就……