剖宫产疤痕妊娠患者血清β-人绒毛膜促性腺激素水平与临床症状的特征分析

Analysis of serum levels ofβ-hCG and clinical characteristics in patients with low implantation ectopic pregnancy

目的探讨低位着床异位妊娠(cesarean scars pregnancy,CSP)患者血清β-人绒毛膜促性腺激素(β-HCG)水平与临床症状的特征分析。方法选取2018年1月至2019年11月经我院妇产科确诊为剖宫产疤痕CSP患者98例,以及同期正常妊娠妇女作为对照组,收集患者的人口学特征资料,既往孕育情况,于终止妊娠当日行血β-HCG检查及超声检查,收集血β-HCG水平和孕囊、胎心监测数据。随后根据植入深度及终止妊娠手术方法不同将患者进行分组比较。结果浅表植入患者β-HCG水平明显低于深层植入患者(P<0.05)。与正常妊娠相比,浅表植入β-HCG水平差异无统计学意义(P>0.05),深层植入β-HCG水平则明显增高(Z=2.399,P=0.016)。根据终止妊娠的手术情况,98例CSP患者中单纯CSP患者69例,复杂CSP患者29例。组间比较,单纯CSP患者年龄、孕囊最大直径以及浅表植入人数均较复杂CSP患者明显增加,而孕龄明显缩短(P<0.05)。单纯CSP和复杂CSP患者β-HCG水平分别与正常妊娠妇女比较差异均无统计学意义(P>0.05)。结论CSP患者在妊娠早期其β-HCG水平可呈现为正常妊娠特点,深入植入患者大多表现为β-HCG水平的过度增高,但并不一定会增加手术的难度。

Objective To investigate the serumβ-hCG level and clinical characteristics in patients with low-lying implantation ectopic pregnancy(CSP).Methods We selected CSP 98 patients with cesarean section scar from January 2018 to November 2019 at department of obstetrics and gynecology in our hospital as research objects.At the same time,we selected the normal pregnant women as controls.Then,the demographic information of patients such as age,body index and history of cesarean section were collected.On the termination day,bloodβ-hCG assay and ultrasonic inspection were performed.Bloodβ-hCG levels,pregnancy sac,and cardiac monitoring data were collected and compared according to the depth of implantation and different methods of operation for termination of pregnancy.Results The level of positive hCG in patients with superficial implantation was significantly lower than that in patients with deep implantation(P<0.05).The levels of hCG level in the superficial implantation were not significantly different from the normal pregnancy(P>0.05)while hCG levels in the deep implantation were significant increased(Z=2.399,P=0.016).According to the surgical conditions of termination of pregnancy,69 were simple CSP patients and 29 were complex CSP patients.For intergroup comparison,the age,maximum diameter of the pregnancy capsule and the number of superficial implantation in simple CSP patients were significantly increased while the gestational age was significantly shortened when compared to complex CSP patients(P<0.05).There was no statistically significant difference in theβ-hCG levels of patients with simple or complex CSP when compared with those with normal pregnancy(P>0.05).Conclusion CSP patients'β-hCG level in the early pregnancy can be shown as the characteristics of normal pregnancy.The excessive increase ofβ-hCG level was related to the depth of implantation,but it does not necessarily increase the difficulty of surgery.