米非司酮和甲氨蝶呤治疗子宫切口瘢痕妊娠的临床分析

摘要

Objective To study the effects of mifepristone and methotrexate therapy on uterine scar pregnancy .Methods 52 pa‐tients with uterine scar pregnancy treated in hospital from June 2012 to June 2014 were enrolled in the study ,who were randomly divided into 2 groups control group and observation group .There were 26 patients in each group .The patients in control group were treated with methotrexate ,while the observation group were treated with mifepristone and methotrexate .Curative effect ,adverse re‐action ,time indexes and serum level of β‐human chorionic gonadotropin(β‐HCG) were statistically analyzed .Results The total ef‐fective rate of observation group was 96 .15% ,while that of the control group patients was 69 .23% ,the difference between the two groups was statistically significant(P<0 .05) .Before treatment ,the serum β‐HCG levels of the patients in observation group and control group were (2 375 .36 ± 48 .73) and (2 350 .31 ± 49 .29) IU/L respectively .There was no statistically significant difference between the two groups(P>0 .05) .After 7 days′treatment ,theβ‐HCG levels of the two groups decreased significantly ,and the lev‐el of observation group was significantly lower than the control group(P<0 .05) .The time for the plump to disappear at scar site , length of stay and serum beta hCG clearance time of patients in observation group were (15 .83 ± 4 .56) ,(8 .20 ± 3 .50) ,(7 .35 ± 1 .82)d respectively ,which were shorter than that in control group ,the difference was statistically significant(P<0 .05) .There was no significant difference in the incidence of adverse reactions between the two groups(P>0 .05) .Conclusion Mifepristone in com‐bination with methotrexate used in the treatment of uterine scar pregnancy help patients recover quickly .%目的：探讨米非司酮和甲氨蝶呤治疗子宫切口瘢痕妊娠的效果。方法选取于2012年6月至2014年6月于该院接受治疗的52例子宫切口瘢痕妊娠的患者，分为对照组和观察组，每组26例。对照组采用甲氨蝶呤治疗，观察组采用甲氨蝶呤联合米非司酮治疗，对两组患者的疗效、不良反应发生情况、各项时间指标和血清β‐人绒毛膜促性腺激素（β‐HCG）水平的变化进行统计分析。结果观察组患者总有效率为96．15％，对照组患者总有效率为69．23％，两组比较差异有统计学意义（ P＜0．05）。治疗前，观察组患者血清β‐HCG水平为（2375．36±48．73）IU／L ，对照组为（2350．31±49．29）IU／L ，两组间比较差异无统计学意义（P＞0．05）。治疗7 d后，两组的β‐HCG水平均明显下降，而且观察组患者明显低于对照组，差异均有统计学意义（P＜0．05）。观察组患者包块消失时间、住院时间及血清β‐HCG转阴时间分别为（15．83±4．56）、（8．20±3．50）、（7．35±1．82）d ，均短于对照组患者，差异有统计学意义（P＜0．05）。两组患者间不良反应发生率比较，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子宫切口瘢痕妊娠有利于患者的恢复。