不同治疗方案下输卵管妊娠患者生育结局研究.docVIP

不同治疗方案下输卵管妊娠患者的生育结局研究 　　【摘要】目的：探讨不同治疗方案下对输卵管妊娠患者生育结局的影响。方法：回顾性分析2009年1月至2012年12月我院收治的362例输卵管妊娠患者不同治疗方案，其中期待疗法98例（A组），药物治疗120例（B组），手术治疗144例（C组），随访2年内的生育结局情况。结果：治疗后A、B、C组患者HCG下降至正常的平均时间分别为（266±115）d、（115±30）d、（131±21）d， 3组间差异有显著性（P005）；A、B、C组患者的患侧输卵管通畅率分别为386%、698%、754%， 3组间差异有显著性意义（P005）；A、B、C组患者2年内妊娠率分别为为571%、725%、806%，3组比较差异有统计学意义（P005）；重复异位妊娠率分别为184%、125%、97%；继发不孕率分别为245%、150%、97%，A组患者与B、C组患者间差异均有统计学意义（P005）。结论：药物治疗的治疗效果明显优于期待疗法，而手术治疗的效果又优于药物治疗，应该根据患者对生育要求的不同选择适当的治疗方案。 　　【关键词】不同治疗方案；输卵管妊娠；生育结局；影响 　　【Abstract】Objectives： To explore the pregnancy outcome of patients received different treatments for tubal pregnancy. Methods： A retrospective analysis was done on the 362 tubal pregnancy patients received different treatments from January 2009 to December 2012 in our hospital. There were 98 cases received expectant treatment （group A）， 120 cases received drug treatment （group B）， and 144 cases received surgical treatment of （group C）. The birth outcomes were followed up for 2 years. Results： After treatment， average time of HGG dropping to the normal value in group A， B， C were （26.6 ± 11.5） d， （11.5 ± 3.0）d and （13.1 ± 2.1）d， respectively. There were significant differences between the three groups （P005）； the tubal patency rate of group A， B and C was 38.6%， 69.8% and 75.4%， respectively， with significant differences among the three groups （P005）. The 2-year pregnancy rate of group A， B， C was 571%， 72.5% and 806% respectively， with significant differences among three groups （P005）； the repeated ectopic pregnancy rate of the three groups was 18.4%， 12.5% and 18.4% respectively； Secondary infertility rates of the three groups was 24.5%， 15.0% and 9.7%， respectively. The difference between patients of group A and patients of group B and C was statistically significant （P005）. Conclusion： The therapeutic effect of drug therapy is obviously better than expectant treatment， and the effect of surgical treatment is better than drug therapy. Appropriate treatment methods