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目的 :探讨局部注射氨甲喋呤 (MTX)配合口服米非司酮 (RU4 86 )在早期宫外孕保守治疗中的疗效。方法 :对早期异位妊娠患者采用阴超介入性穿刺局部注射 MTX 5 0 mg/ m2 。选择 4 0例穿刺成功并符合入选条件的患者随机分为两组 :A组单用 MTX,B组在使用 MTX同时口服 RU4 86 。结果 :4 0例全部治疗成功 ,B组在加速 HCG下降、缩短 HCG转阴时间及平均住院时间方面明显优于 A组 (P <0 .0 5 ) ,且不增加毒副反应。结论 :MTX局部给药配合 RU4 86 口服治疗早期异位妊娠确能提高疗效、缩短疗程 ,并可能使疗程中输卵管破裂的危险减小。对 HCG下降过慢者追加 MTX化疗可预防和治疗持续异位妊娠。
Objective: To investigate the efficacy of local injection of methotrexate (MTX) combined with oral mifepristone (RU4 86) in the conservative treatment of early ectopic pregnancy. Methods: The patients with early ectopic pregnancy were treated with MTX 50 mg / A total of 40 patients with successful puncture and eligible criteria were randomly assigned to two groups: group A with MTX only, group B with MTX and RU 466 at the same time. Results: All 40 cases were successfully treated. Group B was significantly better than group A in accelerating the decrease of HCG, shortening the time of HCG negative conversion and average length of stay (P <0.05), and did not increase the toxicity. Conclusion: MTX topical administration with RU4 86 oral treatment of early ectopic pregnancy can indeed improve the efficacy, shorten the course of treatment, and may reduce the risk of tubal rupture during the course of treatment. Additional MTX chemotherapy for those with slow HCG decline may prevent and treat persistent ectopic pregnancy.