甲氨蝶呤治疗145例异位妊娠回顾性分析

摘要

Objective: To apply for the clinical use of Methotrexate in treatment of ectopic pregnancy, and provide a theoretical basis. Methods: Clinical data of 145 cases of ectopic pregnancy treated with MTX in Jiangsu Provincial People's Hospital from 2002 to 2008 was retrospectively analyzed. Results: Before treatment, serum β-hCG levels were below 1000 U/L, and there was no significant difference between the single treatment and 8 d therapy, additional treatment rates and the in cidence rate of adverse reactions were not significantly different. No significant difference was found between the blood 3-hCG s￡l 000 LJ/L group and 1 000-2 000 LJ/L group in 8 d therapy, but higher than P-hCG>2 000 LJ/L group. There was also no significant difference between the two groups of transfer rates of surgery, but all lower than the last group. Conclusion: When the blood β -hCG levels are below 1 000 LJ/L, the single MTX treatment should be recommended. When serum β-hCG levels are above 2 000 LJ/L, the MTX efficacy is reduced and increased risk of transfer surgery.%目的:为临床合理应用甲氨蝶呤(MTX)治疗异位妊娠提供理论依据.方法:回顾性分析2002～2008年江苏省人民医院妇产科145例患者应用MTX治疗的临床资料.结果:在治疗前血人绒毛膜促性腺激素(β-hCG)水平低于1 000 U/L时,单次治疗和8 d疗法的疗效差异无统计学意义(P＞0.05),补充治疗率和副反应发生率均无明显差异(P＞0.05).8 d疗法的疗效在血β-hCG ≤1 000 U/L组和1 000～2 000 U/L组之间差异无统计学意义(P＞0.05),但均较血β-hCG>2 000 U/L组高,前两组转手术治疗率差异无统计学意义(P＞0.05),但均低于最后一组.结论:当血β-hCG水平低于1 000 U/L时,推荐使用MTX单次治疗;血β-hCG水平高于2 000 U/L时MTX疗效降低,且转手术治疗几率增加.