151例异位妊娠保守治疗临床疗效分析

Conservative treatment of Ectopic Pregnancy: an Analysis of 151 cases

目的探讨不同的保守治疗方案治疗异位妊娠的临床疗效。方法回顾性分析了2002年1月至2012年12月在我院采用不同的保守治疗方案治疗异位妊娠患者151例,总结分析两种药物组和手术保守治疗组的治疗效果。结果 A组(MTX)治愈率为82,61%;B组(MTX+RU486)治愈率为86.05%;C组(手术保守治疗)治愈率为96.77%;A组(MTX)和B组(MTX+RU486)治愈率差异无统计学意义(P>0.05);A组(MTX)与手术保守治疗C组治愈率比较差异(P<0.05);B组(MTX+RU486)与手术保守治疗C组治愈率比较也差异有统计学意义(P<0.05);C组(手术保守治疗)患者血清HCG降到正常时间明显短于药物组A组和B组(P<0.05);而A组和B组没有明显差异(P>0.05);C组血清HCG下降幅度明显大于A组和B组(P<0.05);A组和B组差异无统计学意义(P>0.05)。结论三种保守治疗早期异位妊娠均有效,手术保守治疗能缩短住院治疗时间,药物保守治疗可避免因手术给患者带来的创伤、痛苦及瘢痕、周围组织粘连和术后并发症,同时更为经济方便。治疗过程中检测血清HCG极为重要。

Objective To investigate the clinical effect of different conservative treatment of ectopic pregnancy. Methods Using a retrospective cohort, we collected 151 cases that received conservative treatment for ectopic pregnancy from Jan.2002 to Dec.2012.They were divided into three groups. Analyzed them respectively.Results The cure rate of group A （MTX） was 82.61%.The cure rate group B （MTX＋RU486） was 86.05%.The cure rate group C （conservative surgery） was 96.77%; There was no significant difference between group A and group B in the aspect of cure rate （P0.05）.But there was significant difference between group A and group C as well as group B and group C. The mean time for decline of serum HCG to normal levels was significantly shorter in group C than group A and group B. There was no significant difference between A and B （P0.05）.The decreased percentage of serum HCG was significantly greater in group C than group A and group B. There was no significant difference between A and B （P0.05）. Conclusion The three different conservative treatments were effective for patients with early ectopic pregnancy. Surgical conservative treatment is able to reduce hospitalization time. But drug conservative treatment protects patients from wound, pain, scar, adhering to surroundings and post-operative complications brought by surgery. Moreover, it is more economical and convenient. Monitoring of serum HCG during the treatment is very important.