摘要
目的分析异位妊娠保守治疗的方法及疗效。方法选取33例异位妊娠患者作为研究对象,均给予保守治疗,包括期待治疗及甲氨蝶呤(MTX)、米非司酮、中药等不同药物联合治疗方法 ,观察分析患者的保守治疗效果及不良反应发生情况。结果 33例患者中保守治疗成功31例,成功率为93.94%,失败率为6.06%(2/33)。3例经过期待治疗,动态监测血绒毛膜促性腺激素(HCG)变化,入院后血HCG自行下降至100 mIU/ml以下。MTX+中药保守治疗成功4例, MTX+米非司酮+中药保守治疗成功5例,米非司酮+中药保守治疗成功15例,米非司酮+中药保守治疗不满意加用MTX治疗后成功4例。米非司酮+中药保守治疗不满意加用MTX治疗,血HCG下降仍不满意或附件包块增大而改行腹腔镜手术治疗的患者2例。保守治疗期间监测肝肾功能,造成轻微肝功能损害的患者2例,口服双环醇护肝治疗后3 d肝功能正常,未发生白细胞下降。发生轻微口腔溃疡的患者1例,给予康复新漱口后溃疡治愈。发生轻微药物不良反应患者2例,不良反应发生率为6.06%,均为使用MTX者。患者的平均住院天数为14.42 d。结论使用MTX、米非司酮、中药保守治疗异位妊娠是安全、简单、有效的方法。
Objective To analyze the efficacy of conservative therapy for ectopic pregnancy. Methods A total of 33 patients with ectopic pregnancy were selected as subjects, and al received conservative treatment, including expectant treatment and combination therapy of different drugs such as methotrexate(MTX), mifepristone, and traditional Chinese medicine. The conservative treatment effect and side effects of patients was observed and analyzed. Results Among 33 patients, 31 cases were treated successfully with conservative treatment, with success rate as 93.94%, and failure rate as 6.06%(2/33). After expectant treatment, 3 cases were monitored dynamically for changes of serum chorionic gonadotropin(HCG). After admission, the serum HCG decreased to less than 100 mIU/ml. MTX + traditional Chinese medicine conservative treatment succeeded in 4 cases, MTX + mifepristone + traditional Chinese medicine conservative treatment succeeded in 5 cases, mifepristone + traditional Chinese medicine conservative treatment succeeded in 15 cases, mifepristone + traditional Chinese medicine conservative treatment plus MTX treatment succeeded in 4 cases. 2 patients underwent laparoscopic surgery because of unsatisfactory conservative treatment with mifepristone and traditional Chinese medicine plus MTX, and unsatisfactory decrease of blood HCG or enlargement of adnexal mass. Liver and kidney function were monitored during conservative treatment. 2 patients suffered from slight liver function damage. Liver function was normal 3 d after oral dicyclol treatment, and no leukopenia occurred. 1 patient with slight oral ulcer was cured by using Kangfuxin mouthwash. 2 patients had mild adverse reations, and the incidence of side effects was 6.06%. All patients used MTX. The average hospitalization time was 14.42 d. Conclusion Conservative treatment of ectopic pregnancy with MTX, mifepristone and traditional Chinese medicine is a safe, simple and effective method.
作者
吴海芳
WU Hai-fang(Beijing Fangshan District Maternal and Child Health Hospital, Beijing 102488, China)
出处
《中国现代药物应用》
2019年第6期69-70,共2页
Chinese Journal of Modern Drug Application
关键词
异位妊娠
甲氨蝶呤
米非司酮
中药
保守治疗
Ectopic pregnancy
Methotrexate
Mifepristone
Traditional Chinese medicine
Conservative treatment
