异位妊娠药物保守治疗临床分析  

A clinical analysis of medical conservative treatment of ectopic pregnancy

作　　者：王孝忠[1] 曹晓晓[1] 舒慧芳[1] 陈茜[1] 区海[1] 胡喜珍[1] 

机构地区：[1]广州市红十字会医院,广东广州510220

出　　处：《中国妇幼健康研究》2008年第3期230-233,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的阐明异位妊娠保守治疗用药后血清人绒毛膜促性腺激素B亚单位变化规律，揭示影响疗效、用药疗程及治愈时间的临床因素及其相互关系。方法回顾性分析广州市红十字会医院妇产科2003年1月-2007年7月期间药物保守治疗成功的148例异位妊娠患者的临床资料。结果①甲氨喋呤配伍米非司酮用于异位妊娠保守治疗的成功率为93．67％；②首次用药后患者血清人绒毛膜促性腺激素β可出现升高、平台、缓降、速降4种类型，各占总数的14．63％、15．45％、28．46％、41．46％；③治疗前血清人绒毛膜促性腺激素β呈下降趋势者，首次用药有效率（80．30％）高于呈上升趋势者（41．13％），X^2=21.4438，P〈0．001。用药疗程前者少于后者（t=2．6529，P〈0．05）。临床治愈时间前者短于后者（t=5．5490，P〈0．001）；④治疗前血清人绒毛膜促性腺激素β值〈1000IU／L者，首次用药有效率（52．78％）低于血清值大于1000IU／L者（76．32％），差异有统计学意义（X^2=4.4941，P〈0．05）；血清人绒毛膜促性腺激素β在1000-2000IU／L之间时，用药疗程少于血清值低于1000IU／L者及高于2000IU／L者，但无统计学意义。结论影响异位妊娠患者保守治疗疗效、用药疗程及临床治愈时间最重要的因素是治疗前血清人绒毛膜促性腺激素β变化趋势。Objective To clarify change trend in serum β-hCG subunits following conservative treatment with MTX and mifepritone for patients with ectopic pregnancy, and investigate clinical factors influencing therapeutic effect, course of treatment and clinical curing resolution time and their mutual relationships. Methods The clinical data of 148 patients with ectopic pregnancy who received medical conservative treatment in Guangzhou Red Cross Hospital from January 2003 to July 2007 were analyzed retrospectively. Results ①The success rate of medical treatment with MTX combined with mifepristone was 93.67% ;②The patients who received first administration of drugs presented four changing patterns in serum β-hCG： raising, plateau, slowly decreasing and rapidly decreasing, accounting for 14.63%, 15.45%, 28.46% and 41.46%, respectively; ③For those patients with decreasing tendency of serum β-hCG before treatment, the effective rate after first administration of drugs was 80.30%, which was significantly higher than that of those patients whose serum β-hCG changing trend before treatment was raising （41.13% ） （X^2 = 21.4438, P 〈 0. 001 ）. And the former＇ s courses of medical treatment were less than those of the latter （ t = 2.6529, P 〈 0.05）, furethermore, the former＇ s clinical cure time （9.06±2.07days） was shorter than that of the latter（t = 5.5490 ,P 〈0.001） ; ④The effective rate after first administration of drugs in these patients with a level of serum β-hCG lower than 1000IU/L before treatment （52.78%） was significantly lower than in those patients whose serum β-hCG was higher than 1000IU/L before treatment （76.32%） and the difference was significant （X^2=4.4941, P〈0.05）. When the serum β-hCG level was between 1000-2000IU/L, the courses of medical treatment were less than those patients whose serum β-hCG level was lower than 1000IU/L or higher than 2000IU/L, but the difference was not statistically significant. The serum β-hCG level before treatment was not as

关 键 词：异位妊娠 药物治疗 血清人绒毛膜促性腺激素β变化趋势 用药疗程 临床治愈时间 

分 类 号：R714.22[医药卫生—妇产科学]