摘要目的 探讨影响MTX、米非司酮治疗异位妊娠疗效的相关因素.方法 确诊输卵管妊娠147例,月经周期规则,年龄21～42岁,停经时间31～68 d,血β-HCG＜3000 U/L.单次静脉注射MTX75mg,同时口服米非司酮50 mg,每日两次,连续3 d.监测治疗过程中血β-HCG、附件包块大小临床症状.结果 147例患者接受治疗,成功率79.59%,其中在停经50 d内,疗效显著,停经超过60 d者疗效最差,P＜0.01;在血β-HCG＜2000 U/L中,成功率分别为91.89%、83.33%,其疗效无显著性差异P＞0.05,血β-HCG2000～3000 U/L的病例,其疗效明显下降,与前两组比较,差异有显著性P＜0.01;治疗48 h血β-HCG下降速度＞30%者,疗效最佳,与下降10～30%者,差异有显著性,P＜0.05,下降＜10%者,疗效最差,与前两组比较,差异显著P＜0.01;不同输卵管妊娠包块最大直径其疗效差异无显著性P＞0.05.结论 MTX、米非司酮治疗异位妊娠成功率为79.59%,停经时间、血β-HCG值及其下降程度是影响疗效的主要因素,不同输卵管妊娠包块大小对疗效的影响不明显.

abstractsObjective Explore the effects of MTX,efficacy of mifepristone treatment of ectopic pregnancy of the relevant factors.Methods Confirmed 147 cases of tubal pregnancy,the rules of the menstrual cycle,aged 21-42 years old,stopped by the time 31-68 days,blood β-HCG ＜ 3000u / L.Single intravenous injection MTX75 nag,while oral mifepristone 50 mg,twice daily,for 3 consecutive days.The process of monitoring the treatment of blood β-HCG,Annex mass the size of the clinical symptoms.Results 147 cases of patients receiving treatment,the success rate of 79.59%,of which 50 days in the menopause,the effect of significant menopause more than 60 days from the worst effects,P ＜0.01 ;in blood β-HCG ＜2000 u / L,the success rates for 91.89%,83.33%,and its efficacy was no significant difference P＞0.05,plasma β-HCG2000～3000 u / L cases,its efficacy decreased compared with the previous two groups,there was a significant difference P ＜0.01 ;treatment 48-hour blood velocity decreased β-HCG ＞ 30%,the efficacy of the best,with 10～30% decline,and there was a significant difference,P ＜0.05,decrease ＜10%,the efficacy of the worst,with the former two groups,significant difference P＜0.01;different tubal pregnancy maximum diameter of the mass effect of the difference was not significant P＞0.05.Conclusion MTX,mifepristone treatment of ectopic pregnancy success rate of 79.59 percent,stopped by the time value of serum β-HCG and its decline in the extent of the main factors affect the efficacy of different size of tubal pregnancy mass effect was not obvious.