Conservative treatment of ectopic pregnancy compa

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Conservative treatment of ectopic pregnancy compared 2 methods

Methotrexate for conservative treatment of non-compatibility of ruptured ectopic pregnancy is better, is worthy of clinical application. Keywords Conservative treatment of ectopic pregnancy chorionic gonadotropin membrane Document code】【B】【article number 1681 of a zns4 (zoos) ~ a O446-01 is a common gynecological disease, ectopic pregnancy, in recent years has significantly increased its incidence trend, due to the importance of disease in patients, coupled with secondary screening technology (B ultrasound, the blood G-HCG) continues to improve, many ectopic pregnancy before rupture were diagnosed in order to win the time of conservative treatment drugs. Our hospital in April 2000 ~ April 2004 with a single gun intramuscular injection of methotrexate and mifepristone and methotrexate are two methods of non-ruptured ectopic pregnancy treatment, achieved a certain effect, are summarized comparison as follows. 1 Data and methods 1.1 General Information April 2000 ~ April 2004 in our hospital in patients with non-ruptured ectopic pregnancy 40 patients were randomly divided into two groups A and B, and its diagnostic criteria based on history, gynecological examination, blood G -HCG and B-results. Selection criteria: (1) vital signs were normal and no signs of intraperitoneal bleeding; (2) B-show attachment areas of ectopic pregnancy mass ≤ 5cm, and confirmed that no intrauterine gestational sac; (3) liver, kidney function and normal blood . (4) patients agreed or require conservative treatment. The average age of both groups of patients before treatment G-HCG level, maximum diameter of the annex, the difference was not significant (P> 0.05), Table 1. Table 1 General information on the two groups (± s) 1.2 Group therapy in 20 cases, the methotrexate shot 1 single intramuscular injection of 50mg, 7 days after the blood G-HCG decline are not, then an additional injection of 1 ; Group B in 20 cases. Mifepristone early 25mg, late 50mg, for 2 times, total 150ms, taking medication before and after the fasting when the attention 2h, swallow with warm water, the first 3 days intravenous methotrexate 50mg, 1 week after treatment, 2 blood were monitored weekly decline in G-HCG. 1.3 standard clinical cure symptoms, serum G-HCG dropped to normal range, ectopic pregnancy, not to expand or narrow lesions disappeared, gestational sac was reduced and disappeared. 1.4 failure after standard conservative treatment of abdominal pain intensified after 2 weeks of treatment the blood G-HCG did not decrease or increase, not reduce or increase the pelvic mass, bleeding occurred during treatment require surgical exploration were to fail. 1.5 statistical methods test and t test using Y. Author: 678000 Baoshan City, Yunnan Province, People's Hospital of Obstetrics and Gynecology 2 results of the two methods decreased after treatment G-HCG normalization of the situation and time in Table 2. Table 2 After treatment, decline in blood G-HCG (for example) can be seen from Table 2: A, B and two groups of blood G-HCG normalization of time P <0.05, significant difference between the two groups were in the treatment of are due to sudden rupture of internal bleeding and ectopic pregnancy surgery cases, 6 cases of Group A, Group B 3. The use of two anti-cancer drugs are strictly observed in the treatment of adverse drug reactions, nausea, vomiting 5 cases of Group A, Group B in 7 cases, the extent to heavier B; There was no case of liver dysfunction; WBC decrease, Group 7 cases, 9 cases of Group B, but decreased to a lesser extent, are within the normal range; after stopping drug reactions are faster than normal, there is no bodily harm to patients. 3 is a discussion of antimetabolites MTX, inhibition of cell cycle dihydrofolate reductase, interfering with purine nucleotide synthesis, thus inhibiting DNA synthesis and cell replication, MTX on the proliferation of cells and tissues, such as rapid bone marrow, buccal mucosa and gastrointestinal mucosa, and malignant trophoblast cells inhibited】 J. Mifepristone for the anti-progesterone receptor levels, but also has anti-glucocorticoid activity, but not progesterone, androgen, estrogen and anti-estrogenic activity, and progesterone receptor affinity stronger than progesterone 5 times, and competitive binding of endogenous progesterone receptors, causing degeneration of decidua and villi, resulting in bleeding, stop the embryonic development ... 1; this article Comparison of two treatment methods: MTX treatment success rate of single shot injection of 70%, m Combination MTX mifepristone treatment success rate was 85%, so in the conservative treatment of ectopic pregnancy in order to better B method, while method B adverse drug reactions ways stronger than A, but the fluctuations are within the physiological range, Mifepristone in combination with MTX treatment of ectopic pregnancy, can play a synergistic effect between the two high cure rate, healing time is shorter, the method safe and reliable, it is worth using.
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