绒毛膜促性腺激素、孕酮、超声和诊刮联合检测对诊治早期异位妊娠的临床观察

Clinical observation of a combination of ultrasound and diagnostic scratching and serum HCG and progestone testing in diagnosing early ectopic pregnancy

目的寻找一种易掌握、可诊断早期或不典型的异位妊娠及先兆流产的方法。方法对400例尿妊娠试验阳性但超声检查未发现宫内妊娠囊者随机分为A、B两组,A组(200例)为观察组,跟踪化验血β-HCG、孕酮(P),对阴道流血过多且无继续妊娠需要者进行诊刮;B组(200例)对照组仅在等待5～7d后行腹部超声检查,如发现盆腔积液则行后穹窿穿刺以明确诊断。结果A组患者明确诊断时间平均为4d,手术率3%,平均费用1000元左右;B组诊断时间平均为10d,手术率为95%,平均费用4200元左右。结论联合检测可提高异位妊娠的早期诊断率,减少了手术率,既为有生育要求患者保留输卵管的完整性提供了保障,又为患者减轻了经济负担。

Objective To find a palpable early diagnosis measure of atypical ectopie pregnancy and threatened abortion. Method 400 cases of urine pregnancy test positive, but intrauterine pregnancy sac ultrasound negative patients were randomly divided into A group （200 cases, as the observation group）, which were performed blood tests to track β- HCG,progesterone （P） and diagnosing scratch once vaginal hemmorage occurred and there was no need to continue preg- nancy ; and B group （200 cases, as the control group）, which only waited for 5 ～ 7d to undergo abdominal ultrasonography, and were performed with fornix puncture once pelvic fluid was found after. Results As for the A group, the accurate diagnosis time was 4d,operation rate 3% ,and average cost 1000 yuan ,as compared with 10d,95% ,and 4200 yuan for B group. Conclusion Joint detection of ectopic pregnancy can increase the rate of early diagnosis, reduce the rate of operation, maintain the integrity of the fallopian tube,and alleviate patients＇financial burden.