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目的 探讨氨甲喋呤 (MTX)单次肌肉注射治疗输卵管妊娠的疗效 ,并观察失败的相关因素及其数量与失败可能性的关系。方法 对 41例治疗成功和 11例治疗失败病例的临床资料、包块面积改变以及血清β -hCG值的变化进行对比分析。结果 失败组平均停经时间 6 3 4天、血 β -hCG平均 15 776 5IU/L、治疗 3日后 β -hCG平均下降 18 3%、治疗后包块平均面积增加 6 4 2 %。成功组平均停经时间 5 6 4天、血 β -hCG平均30 17IU/L、治疗 3日后 β -hCG平均下降 5 8 9%、治疗后包块平均面积缩小 0 9%。 结论 当血清 β -hCG值≥10 0 0 0IU/L ,治疗 3日后其下降率 <2 5 %、治疗 3日后包块面积增大≥ 5 0 %时 ,治疗极有可能失败。
Objective To investigate the efficacy of methotrexate (MTX) single intramuscular injection in the treatment of tubal pregnancy, and to observe the relationship between the factors related to failure and their numbers and the possibility of failure. Methods The clinical data of 41 cases of successful treatment and 11 cases of failed treatment, the change of mass area and the change of serum β -hCG were compared and analyzed. Results The mean time to menopause in the failure group was 63.4 days. The average blood β-hCG was 15 776 5 IU / L. After 3 days of treatment, the average β-hCG decreased 18.3%. After treatment, the mean mass of the mass increased by 62.4%. The average postmenopausal time of 564 days in the successful group was 30 17 IU / L for blood β -hCG. The average β -hCG decreased 58.9% after 3 days of treatment, and the mean mass of the mass was reduced by 0.9% after 3 days of treatment. Conclusion When the serum β -hCG value is ≥10 0 0 IU / L, the declining rate is less than 25% after the 3rd day of treatment and the mass of the mass is increased ≥ 50% after the 3rd day of treatment, the treatment is very likely to fail.