卢红 董琳

[摘要]目的 探讨米非司酮联合甲氨蝶呤治疗异位妊娠的效果。方法 选取2013年1月～2017年8月我院收治的70例异位妊娠患者作为研究对象，采用简单随机法将其分为对照组和观察组，每组各35例。对照组患者给予甲氨蝶呤治疗，观察组患者给予米非司酮联合甲氨蝶呤治疗。比较两组患者的治疗总有效率、血人绒毛膜促性腺激素（β-HCG）转阴时间、妊娠囊消失时间及不良反应发生率。结果 观察组患者的治疗总有效率（97.14%）高于对照组（80.0%），差异有统计学意义（P<0.05）。观察组患者的血β-HCG转阴时间、妊娠囊消失时间短于对照组，差异均有统计学意义（P<0.05）。观察组患者的不良反应发生率为11.43%，与对照组的20.00%比较，差异无统计学意义（P>0.05）。结论 米非司酮联合甲氨蝶呤治疗异位妊娠患者，效果确切，用药的安全性高，能够有效改善患者的临床症状，促进患者早日康复，有利于形成良好的医患关系。

[关键词]米非司酮；甲氨蝶呤；异位妊娠；血人绒毛膜促性腺激素；不良反应

[中图分类号] R714.22 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0141-03

[Abstract] Objective To explore the effect of Mifepristone combined with Methotrexate in the treatment of ectopic pregnancy. Methods Altogether 70 cases of patients with ectopic pregnancy treated in our hospital from January 2013 to August 2017 were randomly selected as the study objects. They were divided into control group and observation group by simple random method， with 35 cases in each group. The control group was treated with Methotrexate， and the observation group was treated with Mifepristone combined with Methotrexate. The total effective rate， the negative time of blood β-human chorionic gonadotropin （β-HCG）， the disappearance time of the gestational sac and the incidence of adverse reactions were compared between two groups. Results The total effective rate of the observation group （97.14%） was higher than that of the control group （80.0%）， and the difference was statistically significant （P<0.05）. The negative time of blood β-HCG and the disappearance time of the gestational sac in the observation group were shorter than those in the control group， and the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the observation group was 11.43%， compared with 20% in the control group， and the difference was not statistically significant （P>0.05）. Conclusion Mifepristone combined with Methotrexate is effective in the treatment of ectopic pregnancy， the safety of drug use is high， and it can effectively improve the clinical symptoms of patients and promote the recovery of patients as soon as possible， which is beneficial to the formation of a good doctor-patient relationship.

[Key words] Mifepristone； Methotrexate； Ectopic pregnancy； Blood β-HCG； Adverse reactions

異位妊娠（ectopic pregnancy）临床发病率较高，具体指孕卵在子宫腔外着床发育情况，其中最为常见的是输卵管妊娠，占异位妊娠的95%左右，其具体发病与输卵管管腔及其周围组织炎症有关，导致管腔堵塞，使得孕卵无法正常运行，进而在输卵管中停留并着床发育[1-2]。通常情况下患者早期症状不明显，在破裂或流产后方可察觉，但随着血人绒毛膜促性腺激素（β-HCG）检测技术、B超技术等的发展，异位妊娠的检出率明显提高，不少患者在妊娠囊破裂前确诊，为保守治疗提供契机[3-4]。保守治疗以药物治疗方式为主，其中米非司酮应用较为广泛，但其仅对病灶小、β-HCG水平较低的患者作用显著，应用局限性较大，临床日渐重视联合用药研究。……