异位妊娠保守治疗疗效的影响因素

Analysis of clinical characters influencing the conservative therapeutic effect of ectopic pregnancy

目的:探讨药物保守治疗影响异位妊娠治疗效果的临床特征,为进一步临床研究提供资料。方法:选择2003年1月1日～2007年12月31日5年间我院收治确诊为异位妊娠并采用保守治疗的患者75例,采用单用米非司酮与米非司酮和甲氨蝶呤序贯用药两种方法治疗,分析采用药物保守治疗的疗效与年龄、停经天数、血β-HCG值、包块最大径线、有无阴道流血及盆腔积液的关系。结果:两种治疗方法疗效比较差异无统计学意义(P<0.05)。血β-HCG≤10ng/ml及包块直径≤4cm者治愈率均高于血β-HCG>10ng/ml及包块直径>4cm者,二者比较差异有统计学意义(P<0.05)。血β-HCG>10ng/ml及包块最大径线>4cm都是增加异位妊娠药物保守治疗失败的危险因素。停经天数是异位妊娠药物保守治疗失败的保护因素。结论:患者血β-HCG水平及包块大小是药物保守治疗疗效的影响因素。

Objective： To analyze the relationship between the success of conservative therapeutic treatment and clinical characters to find some clinical character influencing the outcome of treatment of ectopic pregnancy for the further clinic investigation. Methods： A retrospective analysis were diagnosed as ectopic pregnancy from 75 patients in our hospital from Jan 1, 2003 to Dec 31, 2007, all of them received conservative therapeutic treatment by single taking Mifepristone and by taking Mifepristone combined with Meth- otrexate. The relationship between the outcome of treatment and some clinical characters, such as age, days of amenorrhea, size of mass, vaginal bleeding and pelvis accumulate liquid, level of β-human chorionic gonadotrophin （β-HCG） were analyzed. Results： Days of amenorrhea, level of β-HCG and size of mass were different in the drug conservative therapeutic effect of ectopic pregnancy （P 〈0.05）. Level of β- HCG over 10 ng/ml and size of mass over 4 cm were the dangerous factor which increase the failure of eonservative therapeutic treatment. The days of amenorrhea conservative therapeutic treatment. Conclusion： Size cing the conservative therapeutic effect. is the protection factor which decrease the failure of of mass and level of β- HCG were the factors influencing the conservative therapeutic effect.