异位妊娠期待治疗成功的因素分析

Relative factors of expectant management of ectopic pregnancy

目的对异位妊娠期待治疗成功的因素进行回顾性分析。方法对山东大学齐鲁医院计划生育科2004年8月至2012年1月186例异位妊娠期待治疗病例进行回顾性分析，不需要手术或药物治疗为治愈组，需要手术或药物治疗的为失败组。结果140例期待治疗成功，治愈率75．27％；治愈组与失败组包块大小经秩和检验，差异无统计学意义（P〉0．05）；两组包块有囊性结构患者例数差异有统计学意义（P〈0．05）。两组初始血β-人绒毛膜促性腺激素（hCG）差异有统计学意义（P〈0．01），初始血β—hCG在ROC曲线上临界点为634IU／L，第3～5天检测β-hCG与初始血β—hCG的比值在ROC曲线上临界点为0．711。结论初始血p—hCG≤634IU／L或第3～5天检测血β—hCG下降为初始的0．711倍时，可期待治疗。包块有无囊性结构是影响期待治疗成功的因素。

Objective To analyze select patients of ectopic pregnancy for expectant management. Methods Retrospective analyses were conducted for the relative factors of 180 cases of ectopic pregnancy with expectant management at Department of Family Planning of our hospital from August 2004 to January 2012. Their general clinical data, clinical manifestations and laboratory tests were collected. The eases requiring neither surgery nor drug therapy belonged to the cure group while the rest fell into the failure group. Results A total of 140 patients were successfully managed with a cure rate of 75.27%. There was no significant difference between two groups in size of mass on ultrasonography （ P 〉 0.05 ）. The cases with gestational sac of mass on ultrasonography had statistical difference between two groups （P 〈0. 05）. Statistical difference existed between two groups （ P 〈 0. 01 ） in initial blood beta-human chorionie gonadotropin （β-hCG）, initial blood β-hCG and D3 -5/D0 （ratio of blood β-hCG at day 3 -5 and initial） were the variables for predicting the likelihood of successful expectant management under the ROC curve. The Youden Index was the largest at an initial bloodβ-hCG of 634 IU/L or D3 -5/DO of 0. 711. Conclusion At bloodβ-hCG≤634 IU/L or D3 -5/DO 〈 0. 711, expectant management may be offered. And mass with gestational sac on ultrasonography is a relative factor of expectant management.