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目的天花粉和甲氨蝶呤在治疗异位妊娠的疗效、副作用及再次妊娠等方面比较。方法回顾性分析2008~2012年间在我院(上海交通大学医学院附属瑞金医院)因输卵管异位妊娠行保守治疗共209例患者的临床资料。根据保守治疗使用药物情况,天花粉组患者145例,甲氨蝶呤组患者64例,比较两组患者药物使用后再次妊娠及血β-HCG下降情况。根据初始血β-HCG分为4组,分别为<200m IU/m L;200≤血β-HCG<500m IU/m L;500≤血β-HCG<1000m IU/m L;1000≤血β-HCG<2000m IU/m L,比较天花粉组和甲氨蝶呤组疗效、住院时间、转阴时间、副反应。结果在β-HCG“200≤血β-HCG<500m IU/m L”组和“1000≤血β-HCG<2000m IU/m L”组中,天花粉组治愈成功率为89.6%和83.3%,住院时间为(6.60±1.69)和(8.23±4.53),甲氨蝶呤组治愈成功率为66.7%和0,住院时间为(10.39±5.27)和(17.00±8.19),两组比较差异有统计学意义(P<0.05)。天花组血β-HCG转阴时间短于甲氨蝶呤组(P<0.05),但副反应及再次妊娠方面两组差异无统计学意义(P>0.05)。结论天花粉在规范使用下,是一种安全可行、有效的保守治疗药物,与甲氨蝶呤相比,各方面皆有优势。
Objective To compare the efficacy, side effects and re-pregnancy of TCS and methotrexate in the treatment of ectopic pregnancy. Methods The clinical data of 209 patients with conservative treatment of tubal ectopic pregnancy in our hospital (Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine) from 2008 to 2012 were retrospectively analyzed. According to conservative treatment of drug use, TC group of 145 patients, methotrexate group of 64 patients, comparing the two groups of patients after pregnancy and blood β-HCG decreased. According to the initial blood β-HCG is divided into four groups, respectively, <200mIU / m L; 200≤ blood β-HCG <500mIU / m L; 500≤ blood β-HCG <1000mIU / m L; -HCG <2000m IU / m L, compared with TCS and methotrexate group efficacy, hospital stay, overcast time, side effects. Results In the group of β-HCG “200 ≤ blood β-HCG <500 m IU / m L” and “1000 ≤ blood β-HCG <2000 m IU / m L”, the success rate of TC was 89.6% And 83.3% respectively. The hospital stay was (6.60 ± 1.69) and (8.23 ± 4.53) respectively. The success rate of methotrexate treatment was 66.7% and 0, and the length of hospital stay was (10.39 ± 5.27) and (17.00 ± 8.19) The difference was statistically significant (P <0.05). The timing of negative conversion of β-HCG in the smallpox blood was shorter than that in the methotrexate group (P <0.05). However, there was no significant difference between the two groups in side effects and pregnancy (P> 0.05). Conclusion TCS is a safe, feasible and effective conservative treatment under standard use. It has advantages over methotrexate in all aspects.