摘要
目的 :探讨甲氨蝶呤单次肌肉注射治疗异位妊娠的疗效 ,并分析其治疗失败的相关因素。方法 :对比分析成功组及失败组的临床资料 ,包括停经天数、治疗前 β HCG值、包块直径、腹痛情况、治疗 3d后 β HCG值下降率及包块直径改变情况。 结果 :成功组停经天数平均为 5 3± 5d ,β HCG值平均为14 83± 2 16IU·L-1,包块直径平均为 2 .9± 0 .9cm ;失败组停经天数平均为 6 2± 6d ,β HCG值平均为6 6 6 1± 12 6IU·L-1,包块直径平均为 4 .1± 0 .6cm。成功组有 14 .3%的病人停经天数≥ 6 0d ,11.4 %的病人血 β HCG值≥4 0 0 0IU·L-1,治疗 3d后 β HCG值下降率≤ 15 %的为 14 .3% ,包块直径增加≥2 5 %的为 7.9% ;而失败组各数值分别为 4 0 .0 %、80 .0 %、6 0 .0 %、4 0 .0 %。结论 :甲氨蝶呤是一种有效的治疗早期异位妊娠的药物 ;治疗前的 β HCG值、治疗 3d后 β HCG值下降率及包块直径改变情况与治疗失败关系极大 ;胎心搏动并非为异位妊娠药物治疗的禁忌证。
AIM: To evaluate the therapeutic efficacy and failure factors in single dose methotrexate intramusculr injection in treatment of ectopic pregnancy. METHODS: The clinical data of 70 successfully treated cases and 10 failed cases were analyzed comparatively,including the duration of menoschesis,serum β-HCG level,diameter of adnexa mass and abdominal pain before treatment as well as the decline rate of serum β-HCG level and change of mass diameter after 3 d of treatment. RESULTS: In succeeded group,the average duration of menoschesis,the mean level of serum β-HCG and average diameter of adnexa mass were 53±5 d ( 14.3 % of patients≥60 d),1483±216 IU·L -1 ( 11.4 % of patients≥4000 IU·L -1 ) and 2.9 ± 0.9 cm( 7.9 % of patients showed increase of mass diameter≥25%),respectively;whereas in failed group,these corresponding figures were 62±6. d( 40.0 %),6661±126 IU·L -1 ( 80.0 %), 4.1 ± 0.6 cm ( 40.0 %),respectively. After 3 d of treatment, 14.3 % of patients in succeeded group revealed a decline rate of serum β-HCG level≤15%,while 60.0 % of patients in failed group revealed a similar decline rate. CONCLUSION: Methotrexate is an effective drug for treating ectopic pregnancy in its early stage. The serum β-HCG level before treatment,its decline rate and the change of adnexa mass diameter after 3 d of treatment are closely related to the therapy failure. Presence of fetus heart beating is not a contraindication for drug treatment of ectopic pregnancy.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2004年第5期592-594,共3页
Chinese Journal of Clinical Pharmacology and Therapeutics
