摘要
目的:探讨血清-βHCG在输卵管妊娠保守性治疗后疗效观察的价值及其相关因素。方法:回顾性分析保守性治疗输卵管妊娠145例,其中药物治疗组62例(A组),单纯保守性手术38例(B组),保守性手术加术中输卵管局部注射甲氨蝶呤(M TX)10m g 45例(C组)。治疗后定期监测血清-βHCG变化并分析相关因素。结果:A组中保守治疗成功58例,4例保守治疗失败改手术治疗;B组36例治疗成功,2例发生持续异位妊娠;C组45例均治疗成功。C组术后血清-βHCG下降至正常时间明显短于A组和B组(P<0.01),B组则短于A组(P<0.01)。治疗前血清-βHCG浓度高者,行保守性手术(B、C组)治疗后降至正常所需时间长,但在A组中无明显相关性;各组停经天数、包块大小、腹腔内积血量均与治疗后血清-βHCG降至正常的时间无明显相关性。结论:连续监测血清-βHCG对异位妊娠保守性治疗后疗效观察及预防持续异位妊娠极为重要。手术中采用输卵管局部注射M TX可缩短术后血清-βHCG恢复至正常的时间。
Objective： To investigate the change of serum β-HCG level in patients with ectopic pregnancy （EP） undergoing conservative treatment and its influencing factors. Methods： Clinical data of 145 EP patients were retrospectively reviewed; of them, medical treatment （group A）, conservative operation （group B） and conservative operation plus oviductal injection of 10 mg of methotrexate （group C） occurred in 62, 38 and 45 cases, respectively. Serum β-HCG concentration was measured before and after therapy. Results; Successful treatment was seen in 58 cases in group A, 36 in group B, and 45 in group C. The recovery time of β-HCG level was signi（icantly lower in group C and group B than that in group A and B and in group C （P〈0.01）, respectively. Initial concentration of β-HCG correlated with the recovery time after treatment in group B and C, but not in group A. The recovery time of β-HCG level was unrelated to menolipsis time, lump size and intraabdominal hematocele. Conclusion; Successive monitoring of serum β-HCG content is helpful to observe the curative effect after conservative treatment in EP and to prevent the onset of persistent EP. Oviductal injection of methotrexate during operation can reduce the recovery time of β-HCG level.
出处
《广东医学院学报》
2006年第5期463-465,共3页
Journal of Guangdong Medical College
