[1]刘淑琴.米非司酮联合甲氨蝶呤治疗宫外孕的安全性和有效性分析[J].医学信息,2023,36(08):131-134.[doi:10.3969/j.issn.1006-1959.2023.08.028]
 LIU Shu-qin.Analysis of the Safety and Efficacy of Mifepristone Combined with Methotrexate in the Treatment of Ectopic Pregnancy[J].Journal of Medical Information,2023,36(08):131-134.[doi:10.3969/j.issn.1006-1959.2023.08.028]
点击复制

米非司酮联合甲氨蝶呤治疗宫外孕的安全性和有效性分析()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年08期
页码:
131-134
栏目:
论著
出版日期:
2023-04-15

文章信息/Info

Title:
Analysis of the Safety and Efficacy of Mifepristone Combined with Methotrexate in the Treatment of Ectopic Pregnancy
文章编号:
1006-1959(2023)08-0131-04
作者:
刘淑琴
(天津市东丽医院妇产科,天津 300300)
Author(s):
LIU Shu-qin
(Department of Obstetrics and Gynecology,Tianjin Dongli Hospital,Tianjin 300300,China)
关键词:
米非司酮甲氨蝶呤宫外孕人绒毛膜促性腺激素
Keywords:
MifepristoneMethotrexateEctopic pregnancyHuman chorionic gonadotropin
分类号:
R714.22
DOI:
10.3969/j.issn.1006-1959.2023.08.028
文献标志码:
A
摘要:
目的 研究米非司酮联合甲氨蝶呤治疗宫外孕的临床安全性和有效性。方法 选取2020年4月-2021年4月我院诊治的84例宫外孕患者为研究对象,采用随机数字表法分为对照组和观察组,各42例。对照组应用单纯甲氨蝶呤治疗,观察组在对照组基础上联合米非司酮治疗,比较两组临床疗效、临床症状改善时间、血清孕酮和人绒毛膜促性腺激素(β-HCG)水平、不良反应发生率以及1年内生育结局。结果 观察组治疗总有效率为95.24%,高于对照组的83.33%(P<0.05);观察组包块和腹痛消失、阴道止血、血β-HCG转阴、孕酮恢复正常、月经复潮时间均短于对照组(P<0.05);两组治疗后血清孕酮、β-HCG水平均低于治疗前,且观察组低于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05);随访1年,观察组宫内妊娠、再次宫外孕、未孕发生率与对照组比较,差异无统计学意义(P>0.05)。结论 米非司酮联合甲氨蝶呤可提高临床治疗宫外孕的疗效,缩短临床症状改善时间,降低孕酮和β-HCG水平,且联合治疗不增加不良反应发生风险,也不影响1年内生育结局,是一种可行、有效的治疗方案。
Abstract:
Objective To study the clinical safety and efficacy of mifepristone combined with methotrexate in the treatment of ectopic pregnancy.Methods A total of 84 patients with ectopic pregnancy diagnosed and treated in our hospital from April 2020 to April 2021 were selected as the research objects. They were divided into control group and observation group by random number table method, with 42 cases in each group. The control group was treated with methotrexate alone, and the observation group was treated with mifepristone on the basis of the control group. The clinical efficacy, improvement time of clinical symptoms, serum progesterone and human chorionic gonadotropin (β-HCG) levels, incidence of adverse reactions and fertility outcomes within 1 year were compared between the two groups.Results The total effective rate of treatment in the observation group was 95.24%, which was higher than 83.33% in the control group (P<0.05). The time of mass and abdominal pain disappearance, vaginal hemostasis, blood β-HCG turning negative, progesterone returning to normal, and menstrual recovery in the observation group were shorter than those in the control group (P<0.05). After treatment, the levels of serum progesterone and β-HCG in the two groups were lower than those before treatment, and those in the observation group were lower than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group (P>0.05). After 1 year of follow-up, there was no significant difference in the incidence of intrauterine pregnancy, ectopic pregnancy and non-pregnancy between the observation group and the control group (P>0.05).Conclusion Mifepristone combined with methotrexate can improve the efficacy of clinical treatment of ectopic pregnancy, shorten the improvement time of clinical symptoms, reduce the levels of progesterone and β-HCG, and the combined treatment does not increase the risk of adverse reactions and does not affect the fertility outcome within 1 year. It is a feasible and effective treatment plan.

参考文献/References:

[1]董云虹.米非司酮联合甲氨蝶呤治疗87例宫外孕的临床分析[J].陕西医学杂志,2016,45(12):1667-1668.[2]杨庆彪,张婷,陆燕,等.甲氨蝶呤联合米非司酮及宫外孕2号方加味治疗宫外孕子宫切口瘢痕妊娠疗效观察[J].现代中西医结合杂志,2018,27(2):160-162.[3]王玉东.2016年英国皇家妇产科医师学会及早期妊娠学会《异位妊娠的诊断和管理》指南解读[J].中国实用妇科与产科杂志,2017,33(9):916-919.[4]徐保华.米非司酮联合甲氨蝶呤保守治疗对宫外孕患者的效果及性功能的影响[J].黑龙江中医药,2019,48(3):192-193.[5]Xiao C,Shi Q,Cheng Q,et al.Non-surgical management of tubal ectopic pregnancy: A systematic review and meta-analysis[J].Medicine (Baltimore),2021,100(50):e27851.[6]杨庆彪,张婷,陆燕,等.甲氨蝶呤联合米非司酮及宫外孕2号方加味治疗剖宫产子宫切口瘢痕妊娠疗效观察[J].现代中西医结合杂志,2018,27(2):160-162. [7]刘瑞景,马述斌,彭海燕,等.甲氨蝶呤联合宫外孕Ⅱ号方与米非司酮治疗异位妊娠的随机对照试验[J].现代诊断与治疗,2017,28(10):1779-1780.[8]苏华.甲氨蝶呤联合米非司酮及宫外孕Ⅱ号治疗宫外孕的临床疗效分析[J].吉林医学,2019,40(11):2578-2579.[9]黄楠.甲氨蝶呤、米非司酮联合中药治疗输卵管妊娠的临床效果分析[J].河南医学研究,2017,26(20):3740-3741. [10]廖绍青,陈丽帆.米非司酮联合宫外孕Ⅱ号方及甲氨蝶呤治疗宫外孕的疗效[J].深圳中西医结合杂志,2019,29(12):39-40.[11]Weant KA,Bailey AM,Baum RA,et al.Chemotherapy in the Emergency Department There Is a Role for That: Methotrexate for Ectopic Pregnancy[J].Adv Emerg Nurs J,2017,39(1):18-25.[12]曲宏伟,贺朝.破血抗孕方结合甲氨蝶呤子宫动脉灌注栓塞术治疗输卵管妊娠疗效观察[J].陕西中医药大学学报,2016,39(3):74-75.[13]Liu QW,Han T,Yang M,et al.ematic review on efficacy and safety of gasless laparoscopy in the management of uterine leiomyoma[J].J Huazhong Univ Sci Technolog Med Sci,2016,36(1):142-149.[14]张玲,王轶凡.异位妊娠不同治疗方案的临床疗效比较及安全性观察[J].宁夏医科大学学报,2018,40(7):810-813.[15]李岩,傅金英,宋晓婕,等.消癥杀胚煎剂口服辅助甲氨蝶呤、米非司酮治疗异位妊娠效果观察[J].山东医药,2018,58(19):51-54.[16]邱菱雅.米非司酮治疗妇产科疾病的临床效果分析[J].浙江临床医学,2020,22(3):391-392,396.[17]Macnaughton H,Nothnagle M,Early J.Mifepristone and Misoprostol for Early Pregnancy Loss and Medication Abortion[J].Am Fam Physician,2021,103(8):473-480.[18]李常虹,黄赞怡,王琼.甲氨蝶呤联合米非司酮治疗宫外孕对患者血清孕酮β-HCG 水平影响分析[J].河北医学,2019,25(4):563-567.[19]周彩霞.米非司酮治疗未破损异位妊娠及对血β-HCG的影响[J].贵州医药,2019,43(7):1121-1123.[20]刘湘,黄宝惠,夏闪.甲氨蝶呤不同给药途径联合米非司酮及微创保守手术治疗输卵管妊娠的临床疗效观察[J].解放军预防医学杂志,2019,37(6):102-103.

相似文献/References:

[1]周 鑫,王 明,魏 宏.药物流产终止乙肝病毒感染患者10~14周妊娠的 安全性及有效性分析[J].医学信息,2018,31(12):112.[doi:10.3969/j.issn.1006-1959.2018.12.035]
 ZHOU Xin,WANG Ming,WEI Hong.Analysis of Safety and Effectiveness of Stopping Hepatitis B Virus Infection in 10 to 14 Weeks of Pregnancy by Drug Abortion[J].Journal of Medical Information,2018,31(08):112.[doi:10.3969/j.issn.1006-1959.2018.12.035]
[2]韩怡波.儿童急淋大剂量甲氨蝶呤延迟解救的安全性研究[J].医学信息,2019,32(19):143.[doi:10.3969/j.issn.1006-1959.2019.19.046]
 HAN Yi-bo.Safety Study on Delayed Rescue of High-Dose Methotrexate in Children[J].Journal of Medical Information,2019,32(08):143.[doi:10.3969/j.issn.1006-1959.2019.19.046]
[3]张 勇.阴道放置米索前列醇在终止6~10周妊娠负压吸宫术前的应用[J].医学信息,2019,32(24):143.[doi:10.3969/j.issn.1006-1959.2019.24.051]
 ZHANG Yong.Application of Vaginal Misoprostol Before Termination of Negative Pressure Uterine Aspiration with 6 to 10 Weeks[J].Journal of Medical Information,2019,32(08):143.[doi:10.3969/j.issn.1006-1959.2019.24.051]
[4]李 丽.米非司酮与乳酸依沙吖啶联合治疗中晚期妊娠引产的临床疗效[J].医学信息,2019,32(24):159.[doi:10.3969/j.issn.1006-1959.2019.24.058]
 LI Li.Clinical Efficacy of Mifepristone Combined with Ethacridine Lactate in the Induction of Labor in Mid-to-late Pregnancy[J].Journal of Medical Information,2019,32(08):159.[doi:10.3969/j.issn.1006-1959.2019.24.058]
[5]丁宇康.化瘀通痹方联合甲氨蝶呤治疗难治性类风湿关节炎的效果[J].医学信息,2019,32(24):171.[doi:10.3969/j.issn.1006-1959.2019.24.063]
 DING Yu-kang.Observation of Huayu Tongbi Recipe Combined with Methotrexate in the Treatment of Refractory Rheumatoid Arthritis[J].Journal of Medical Information,2019,32(08):171.[doi:10.3969/j.issn.1006-1959.2019.24.063]
[6]周文旭,谭湘淑,佘 君,等.类风湿关节炎大鼠滑膜细胞凋亡基因调控的实验研究[J].医学信息,2020,33(05):71.[doi:10.3969/j.issn.1006-1959.2020.05.021]
 ZHOU Wen-xu,TAN Xiang-shu,SHE Jun,et al.Experimental Study on Regulation of Apoptosis Genes in Synovial Cells of Rats with Rheumatoid Arthritis[J].Journal of Medical Information,2020,33(08):71.[doi:10.3969/j.issn.1006-1959.2020.05.021]
[7]张 彬,齐红梅,王红燕,等.高强度聚焦超声联合清宫术治疗剖宫产瘢痕妊娠的疗效[J].医学信息,2020,33(06):115.[doi:10.3969/j.issn.1006-1959.2020.06.035]
 ZHANG Bin,QI Hong-mei,WANG Hong-yan,et al.Efficacy of High-intensity Focused Ultrasound Combined with Uterine Hysterectomy in Cesarean Scar Pregnancy[J].Journal of Medical Information,2020,33(08):115.[doi:10.3969/j.issn.1006-1959.2020.06.035]
[8]李 娟,胡 欣,张小妹.米非司酮联合血府逐瘀汤治疗子宫腺肌病的临床观察[J].医学信息,2021,34(23):168.[doi:10.3969/j.issn.1006-1959.2021.23.051]
 LI Juan,HU Xin,ZHANG Xiao-mei.Clinical Observation of Mifepristone Combined with Xuefu Zhuyu Decoction in the Treatment of Adenomyosis[J].Journal of Medical Information,2021,34(08):168.[doi:10.3969/j.issn.1006-1959.2021.23.051]
[9]段 然.B超引导下宫腔镜电切术联合甲氨蝶呤治疗子宫切口瘢痕妊娠的可行性分析[J].医学信息,2021,34(03):134.[doi:10.3969/j.issn.1006-1959.2021.03.037]
 DUAN Ran.Feasibility Analysis of B-ultrasound Guided Hysteroscopic Resection Combined with Methotrexate in the Treatment of Uterine Incision Scar Pregnancy[J].Journal of Medical Information,2021,34(08):134.[doi:10.3969/j.issn.1006-1959.2021.03.037]
[10]张东霞.米非司酮在子宫内膜异位症患者腹腔镜手术中的应用研究[J].医学信息,2021,34(16):175.[doi:10.3969/j.issn.1006-1959.2021.16.050]
 ZHANG Dong-xia.Application of Mifepristone in Laparoscopic Surgery in Patients with Endometriosis[J].Journal of Medical Information,2021,34(08):175.[doi:10.3969/j.issn.1006-1959.2021.16.050]
[11]范叶柏,宫 雪,杨晓晨.米非司酮联合甲氨蝶呤与单纯甲氨蝶呤治疗宫外孕的临床安全性和有效性比较[J].医学信息,2021,34(13):170.[doi:10.3969/j.issn.1006-1959.2021.13.047]
 FAN Ye-bai,GONG Xue,YANG Xiao-chen.Comparison of the Clinical Safety and Effectiveness of Mifepristone Combined with Methotrexate and Methotrexate Alone in the Treatment of Ectopic Pregnancy[J].Journal of Medical Information,2021,34(08):170.[doi:10.3969/j.issn.1006-1959.2021.13.047]
[12]刘细风.甲氨蝶呤联合米非司酮治疗不同β-hCG水平宫外孕患者的效果[J].医学信息,2021,34(24):138.[doi:10.3969/j.issn.1006-1959.2021.24.035]
 LIU Xi-feng.Effect of Methotrexate Combined with Mifepristone in the Treatment of Ectopic Pregnancy with Different β-hCG Levels[J].Journal of Medical Information,2021,34(08):138.[doi:10.3969/j.issn.1006-1959.2021.24.035]

更新日期/Last Update: 1900-01-01