经阴道超声联合β-HCG对输卵管妊娠治疗方式的指导作用  

The guiding effect of transvaginal ultrasound combined with β-HCG on the treatment of tubal pregnancy

作　　者：焦晓云 柴永红 刘叶廷 孙军华 JIAO Xiaoyun;CHAI Yonghong;LIU Yeting;SUN Junhua(Hebei General Hospital for Veterans,Xingtai,Hebei 054000,China;The First Affiliated Hospital ofXingtai Medical College,Xingtai,Hebei 054000,China)

机构地区：[1]河北省退役军人总医院,河北邢台054000 [2]邢台医专第一附属医院,河北邢台054000

出　　处：《中国优生与遗传杂志》2022年第4期640-644,共5页Chinese Journal of Birth Health & Heredity

基　　金：中药组方联合米非司酮治疗输卵管妊娠的临床研究(2014Zc122)。

摘　　要：目的 探究经阴道超声(TVS)联合β-人绒毛膜促性腺激素(β-HCG)对输卵管妊娠(TP)治疗方式的指导作用。方法 选取我院97例TP患者,均行药物保守治疗,根据是否转腹腔镜手术治疗分为保守组和手术组,比较两组基本资料、治疗前TVS相关指标[子宫内膜厚度(ED)、附件区包块容积、阻力指数(RI)]、血清β-HCG水平;分析治疗前TVS相关指标、血清β-HCG水平预测保守治疗转腹腔镜手术治疗的价值,治疗3个月后统计患者输卵管通畅程度,比较不同输卵管通畅程度患者治疗前与治疗3个月后TVS相关指标、血清β-HCG水平变化值,分析各指标变化值与输卵管通畅程度的相关性。结果 手术组治疗前附件区包块容积及血清β-HCG水平均高于保守组,RI低于保守组(P<0.05);附件区包块容积、RI、血清β-HCG联合预测TP患者保守治疗失败转腹腔镜手术治疗的曲线下面积(AUC)为0.898;输卵管完全通畅患者治疗前、治疗3个月后RI及ΔRI、Δβ-HCG均高于通而不畅、完全不通患者,通而不畅高于完全不通患者,血清β-HCG水平均低于通而不畅、完全不通患者,通而不畅低于完全不通患者(P<0.05);治疗3个月后输卵管通畅程度与ΔRI、Δβ-HCG呈正相关(P<0.05)。结论 TVS联合血清β-HCG在预测TP患者保守治疗失败转腹腔镜手术治疗方面具有良好价值,可指导临床选择治疗方式,且治疗后复查TVS及血清β-HCG可反映输卵管通畅情况。Objective To explore the guiding effect of transvaginal ultrasound(TVS) combined with β-human chorionic gonadotropin(β-HCG) on the treatment of tubal pregnancy(TP). Methods A total of 97 patients with TP in our hospital were selected and received conservative drug treatment. According to whether they were converted to laparoscopic surgery,they were divided into a conservative group and an operation group. The basic data, TVS-related indicators before treatment [endometrial thickness(ED), Adnexal mass volume, resistance index(RI)], serum β-HCG level;TVS-related indicators and serum β-HCG level before treatment were analyzed to predict the value of conservative treatment to laparoscopic surgery, and patients’ fallopian tubes were counted after 3 months of treatment The degree of patency was compared, and the changes of TVS-related indexes and serum β-HCG levels before and after 3 months of treatment were compared in patients with different degrees of tubal patency, and the correlation between the changes of each index and the degree of tubal patency was analyzed.Results Before treatment, the mass volume and serum β-HCG level in the adnexal area in the surgery group were higher than those in the conservative group, and the RI was lower than that in the conservative group(P<0.05). The area under the curve(AUC) of patients who failed to convert to laparoscopic surgery was 0.898;the RI, ΔRI, Δβ-HCG of patients with complete tubal patency before treatment and after 3 months of treatment were higher than those of patients with patency and complete blockage. The patients with patency but not smoothness were higher than the patients with complete blockage, the serum β-HCG level was lower than that of the patients with patency but not smoothness and complete blockade, and the patients with patency but not smoothness were lower than the patients with complete blockade(P<0.05);the degree of tubal patency after 3months of treatment It was positively correlated with ΔRI and Δβ-HCG(P<0.05). Conclusion TVS combined

关 键 词：输卵管妊娠 经阴道超声 Β-人绒毛膜促性腺激素 保守治疗 手术治疗 

分 类 号：R714.22[医药卫生—妇产科学]