停经时间、血β-HCG水平及包块大小对药物治疗异位妊娠疗效的影响

Effects of menopausal time,blood β-HCG level and mass size on the efficacy of drug therapy for ectopic pregnancy

目的探讨米非司酮联合甲氨蝶呤治疗宫外孕的疗效,及与停经时间、血β-人绒毛膜促性腺激素(β-HCG)水平及包块大小的关系。方法 2010年1月1日至2018年12月31日,选取陕西省汉中市南郑区人民医院妇产科无手术指征的宫外孕病人60例行药物保守治疗,住院时准确记录停经天数、测血β-HCG水平及彩超宫外孕包块大小,分析这些指标对保守治疗效果的影响。结果保守治疗60例痊愈44例(73.33%),无效改行手术治疗16例(26.67%)。保守治疗患者血β-HCG水平≤3 000 IU/L、包块≤3cm者痊愈率较高(χ~2=10.947、17.455,均P<0.01)。孕周≤60天痊愈率偏高,但差异无统计学意义(χ~2=3.764、P>0.05)。结论米非司酮联合甲氨蝶呤治疗宫外孕的痊愈率尚不是很高,其疗效与血β-HCG高低、包块大小有关。

Objective To explore the curative effect of mifepristone combined with methotrexate in the treatment of ectopic pregnancy and influence of the time duration of menopause,the level of serum beta-human chorionic gonadotropin(beta-HCG) and the size of the mass.Methods 60 patients with ectopic pregnancy without surgical indications admitted to the hospital during the period from January 1,2010 to December 31,2018,were treated with conservative therapies.The days of menopause,blood beta-HCG level and the size of ectopic pregnancy mass were recorded accurately during hospitalization.The correlation between these indexes and the success or failure of conservative treatment was statistically compared,and the length oftime of menopause was analyzed.The effects of beta-HCG and mass size on the therapeutic effect of drugs on ectopic pregnancy were studied.Results Conservative treatment was successful in 44 cases(73.33%) and failed in 16 cases(26.67%).The success rate of conservative treatment was higher when serum beta-HCG level in conservative treatment patients was lower than or equal to 3 000 IU/L and the mass was smaller than or equal to 3 cm(χ~2=10.947,χ~2=17.455,P<0.01).The success rate of the patients pregnant for less than or equal to 60 days was higher,but there was no statistical difference(χ~2=3.764,P>0.05).Conclusion The recovery rate of mifepristone combined with methotrexate in the treatment of ectopic pregnancy was not very high,and its curative effect was related to the level of blood beta-HCG and the size of mass.