血β-HCG浓度及宫外孕药物保守治疗关系.docVIP

血β-HCG浓度及宫外孕药物保守治疗关系【摘要】 目的 探讨宫外孕药物保守治疗的指征及方案。方法 选取115例宫外孕住院患者，根据血β-人绒毛膜促性腺激素（β-HCG）浓度不同分3组，A组β-HCG≤5000 U/L予氨甲喋呤（MTX）＋米非司酮；B组β-HCG 5000～8000 U/L及C组β-HCG 8000 U/L予MTX＋米非司酮＋5-氟尿嘧啶（5-FU）药物治疗，对其治疗效果及不良反应进行分析研究。结果 ① 115例患者，成功107例，失败8例，总治愈率93．04％，无一例严重不良反应;② β-HCG≤5000 U/L 96例，成功91例，成功率94．79％，β-HCG〉5000 U/L 19例,成功16例，成功率84．21％，二者比较P0．05，差异无统计学意义。结论 本研究显示宫外孕药物保守治疗效果满意，其指征可适当放宽至β-HCG≤5 000 U/L，并应根据β-HCG值、B超检查等综合考虑选择不同药物治疗方案。 【关键词】 宫外孕； MTX；米非司酮；5-FU；β-HCG The Relation of β-HCG Concentration and Conservative Treatment with Drug of Ectopic Pregnancy LI Rong,LI Zhong-hen.The Third People’s Hospital of Mianyang City, Mianyang City,Sichuan 621000,China 【Abstract】 Objective To discuss the indication and regimen of conservative treatment in patients with ectopic pregnancy. Methods 115 patients with ectopic pregnancy were classified into 3 groups according to the level of β-HCG in serum. MTX and mifeprestone was administrated to the first group, MTX and mifeprestone combinated 5-FU was administrated to the others, each group was analyzed in its curative and side effect. Result A. 108 of 115 cases were healed, 7 of them were failed. The gross cure rate is 93．04%. B. The group which β-HCG is under 5000 U/L showed higher curative rates than thoseβ-HCG is over 5 000 U/L(P0．05). Conclusion The conservative treatment with drug for ectopic pregnancy in this study is efficient，especially， in the group of β-HCG under 5000 U/L. So, it is necessary to properly select the indication of conservative treatment for patients with ectopic pregnancy, and treatment regimen according to the change of β-HCG in serum and result of ultrasound detection. 【Key words】 Ectopic pregnancy； MTX； Mifeprestone； 5-FU； β-HCG 近年来,宫外孕发生率逐年上升[１]，对育龄妇女身心造成严重损害，但随着育龄妇女自我保健意识及医生对宫外孕重视程度的共同提高、先进检测技术的应用（如 β-HCG的测定，高分辨率B超的应用等）使宫外孕得以早期诊断，为其早期治疗创造了条件，早期治疗中要求保守治疗的日趋增多，而且在既往认为不宜行宫外孕保守治疗的患者中亦有相当比例要求保守治疗，因此我们在临床工作中适当放宽了宫外孕保守治疗的指征，并且针对不同适应症采取不同治疗方案，取得了满意疗效，现总结如下。 1 资料与方法 1．1 一般资料 2006年6月至2007年6月在泸州医学院附属医院住