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目的探讨不同剂量甲氨蝶呤(MTX)与米非司酮联合治疗异位妊娠的疗效及成本-效果分析。方法 99例异位妊娠患者分为3组,对照组36例:MTX50mg/m2单次肌肉注射治疗;A组33例:MTX50mg/m2单次肌肉注射加米非司酮150mg顿服;B组30例:MTX40mg/m2单次肌肉注射加米非司酮150mg顿服。结果 A、B两组血β-hCG降至正常时间低于对照组(P﹤0.05),且A、B两组包块下降值高于对照组(P﹤0.05),B组药物副反应低于对照组(P﹤0.017);3组的成本-效果比(C/E)为:0.855,0.882,0.753;以对照组为参照,A、B两组的增量成本-效果比(△C/△E)为1.17,-0.46。结论甲氨蝶呤联合米非司酮治疗异位妊娠效果好,联合用药可适当减少甲氨蝶呤的用量,且副反应少;B组的C/E和△C/△E最低,为最佳治疗方案。
Objective To investigate the efficacy and cost-effectiveness of different doses of methotrexate (MTX) combined with mifepristone in the treatment of ectopic pregnancy. Methods 99 cases of ectopic pregnancy were divided into three groups, 36 cases in the control group: single intramuscular injection of MTX50mg / m2; A group of 33 cases: MTX50mg / m2 single intramuscular injection of mifepristone 150mg Dayton; B group 30 Example: MTX40mg / m2 single intramuscular injection of mifepristone 150mg Dayton clothing. Results The β-hCG levels in A and B groups were lower than those in control group (P <0.05), and the values in A and B groups were significantly lower than those in control group (P <0.05). The side effects of B group were lower (P <0.017). The cost-effectiveness ratio (C / E) was 0.855,0.882,0.753 in the three groups. Compared with the control group, the incremental cost-effectiveness ratio (△ C / ΔE) was 1.17, -0.46. Conclusion Methotrexate combined with mifepristone is effective in treating ectopic pregnancy. Combined use of methotrexate and mifepristone may reduce the dosage of methotrexate with fewer side effects. The C / E and △ C / △ E in group B are the lowest Good treatment program.