301例异位妊娠药物保守治疗影响因素的临床分析

Clinical analysis of influence factor in the medical conservative treatment for 301 patients with ectopic pregnancy

目的探讨影响异位妊娠药物保守治疗成功率的因素。方法对山西医科大学第一附属医院2011年1月~2013年12月收治的301例药物保守治疗的异位妊娠病例进行回顾性的分析,将药物治疗的所有病例分为成功组及失败组,比较两组间的临床表现、B超检查结果、以及入院时血β-HCG水平的差别,并用Logistic回归分析影响药物治疗成功率的因素。结果单因素分析结果显示,入院时血β-HCG水平、B超显示包块的直径大小影响异位妊娠患者药物治疗的成功率（P〈0.05）;而年龄、停经天数、有无腹痛及阴道流血和入院时B超显示盆腔积液深度均无明显影响（P〉0.05）。Logistic分析结果显示,血清β-HCG水平以及盆腔包块直径的大小是药物治疗成功率的影响因素。结论血β-HCG水平、包块大小是影响异位妊娠药物保守治疗成功率的关键因素,应根据其临床症状和辅助检查选择合适的治疗方案,以提高药物治疗的成功率。

Objective To investigate the factors affecting success rate of drug conservative treatment in ectopic pregnancy. Methods 301 patients with ectopic pregnancy, who were treated by medical conservative treatment in the first affiliated hospital from January 2011 to December 2013, were retrospectively analyzed and divided into success group and failure group. The differences of two groups on clinical history schedule, B ultrasound inspection result, and the level of β-HCG in blood on admission were compared. Factors of the success rate were analyzed through Logistic regression analysis. Results Signal factor analysis showed that the level of β-HCG in blood on admission and the diameter size of mass by B ultrasound had influenced the success rate of medicine conservative treatment for the patients with ectopic pregnancy （P 〈 0.05）, but days of menopause, abdominal pain, vaginal bleeding and the depth of effusion in pelvic cavity by B ultrasound inspection had not influenced the success rate （P〉0.05）. The Logistic regression analysis showed that the level of β-HCG in blood and the diameter size of mass in pelvic cavity were factors influence the success rate of medicine conservative treatment. Conclusion The level of β-HCG in blood and the diameter size of mass are key factors influence the success rate of medical conservative treatment of ectopic pregnancy. According to the clinical symptoms and auxiliary examination, choose the appropriate treatment can improve the success rate of drug therapies.