输卵管妊娠保守适应证选择的研究

Cinical value of CDFI-based pretherateutic score for medical treatment of ectopic pregnancy

目的探讨彩色多普勒超声(CDFI)筛选合适药物保守治疗异位妊娠的临床价值。方法50例生命体征平稳的异位妊娠患者,在行CDFI检查后接受甲氨蝶呤(MTX)50mg/m2单次肌肉注射配合米非司酮150mg,三日口服,随访直至临床结局.分析成功与失败病例CDFI的特点和绒毛膜促性腺激素(H CG)的水平,并制作CDFI评分。结果CDFI能直接反映胚胎生命力,不同CDFI图像和血清HCG水平的病例,保守治疗成功率有很大差异。结论CDFI评分可应用于适合保守治疗异位妊娠病例的筛选。对评分>9者,因失败率高,不推荐药物保守治疗。

Objective:To explore the clinical value of CDFI in selecting ectopic pregnancies(EP) suitable for medical treatment.Methods:50 cases of ectopic pregnancy with hemotodynamic stability were inject with a single dose of methotexate(MTX)by 50mg/m2 after a CDFI examination..All patients were followed up until clinical results were confirmed.then the characteristics of the failure and the success were analysed.In comdination with serumhuman chorionic gonandotropin(HCG)level,a CDFI-based pretheraperapeutic score were designed.Results:CDFI can reflect the viability of ectopic sac directly.There is a significant difference beteen variable type of CDFI images and serum HCG levels.Conclusion:The CDFI-based pretherapeutic score is useful for the selection of EP.cases suitable for medical treatment.Patients with the score>9 are encounting a high rate of failure,thus medical treatment is not recommended to them