阴道超声检查指标联合人绒毛膜促性腺激素判断输卵管妊娠保守治疗效果的价值  

Value of Vaginal Ultrasonography Combined with Human Chorionic Gonadotropin in Judging the Effect of Conservative Treatment of Tubal Pregnancy

作　　者：吴士爱 WU Shi′ai(Department of Obstetrics and Gynecology,Tianjin Port Hospital,Tianjin 300450,China)

机构地区：[1]天津港口医院妇产科,天津300450

出　　处：《医学信息》2025年第2期132-135,共4页Journal of Medical Information

摘　　要：目的研究阴道超声检查指标联合人绒毛膜促性腺激素判断输卵管妊娠保守治疗效果的价值。方法回顾分析2021年4月-2023年1月我院保守治疗的80例输卵管妊娠患者临床资料,均采用甲氨蝶呤与米非司酮保守治疗,依据治疗结果分为成功组(n=66)和失败组(n=14),比较两组人绒毛膜促性腺激素(β-h CG)水平、阴道超声检查指标(子宫内膜厚度、血流分级),并采用受试者工作特征(ROC)曲线分析不同指标(阴道超声检查指标、β-hCG、经阴道超声检查指标+β-hCG)判断保守治疗治疗失败风险的价值。结果成功组治疗第4、7天血清β-hCG均低于失败组,治疗第4~7天变化率大于失败组(P<0.05);成功组子宫内膜厚度、血流分级均优于失败组(P<0.05);ROC曲线分析显示,阴道超声检查指标(子宫内膜厚度+血流分级)+血清β-hCG水平判断输卵管妊娠保守治疗失败风险曲线下面积高于阴道超声检查指标、血清β-hCG水平单一检测(P<0.05)。结论阴道超声检查指标联合血清β-hCG判断输卵管妊娠保守治疗效果具有良好的价值,可一定程度评估治疗失败风险,为临床有效、安全治疗提供可靠参考。Objective To study the value of transvaginal ultrasound combined with human chorionic gonadotropin in judging the effect of conservative treatment of tubal pregnancy.Methods The clinical data of 80 patients with tubal pregnancy treated conservatively in our hospital from April 2021 to January 2023 were retrospectively analyzed.All patients were treated conservatively with methotrexate and mifepristone.According to the treatment results,they were divided into success group(n=66)and failure group(n=14).The levels of human chorionic gonadotropin(β-hCG)and vaginal ultrasound examination indexes(endometrial thickness and blood flow grade)were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the value of different indexes(vaginal ultrasound index,β-hCG,transvaginal ultrasound indexes+β-hCG)in judging the risk of conservative treatment failure.Results The serumβ-hCG in the successful group was lower than that in the failure group on the 4th and 7th day of treatment,and the change rate on the 4th to 7th day of treatment was higher than that in the failure group(P<0.05).The endometrial thickness and blood flow grading in the successful group were better than those in the failure group(P<0.05).ROC curve analysis showed that the area under the curve of vaginal ultrasound examination index(endometrial thickness+blood flow classification)+serumβ-hCG level to judge the failure risk of conservative treatment of tubal pregnancy was higher than that of vaginal ultrasound examination index and serumβ-hCG level(P<0.05).Conclusion Transvaginal ultrasonography combined with serumβ-hCG has a good value in judging the conservative treatment effect of tubal pregnancy,which can evaluate the risk of treatment failure to a certain extent and provide a reliable reference for clinical effective and safe treatment.

关 键 词：子宫内膜厚度 血流分级 人绒毛膜促性腺激素 输卵管妊娠 保守治疗 

分 类 号：R714.2[医药卫生—妇产科学]