摘要
目的:探讨血清绒毛膜促性腺激素(HCG)水平及经阴道彩色多普勒超声(TVCD)在选择合适药物保守治疗异位妊娠患者方面的临床价值。方法:50例生命体征平稳的异位妊娠患者,在行TVCD检查后接受甲氨蝶呤(MTX)50 mg/m2单次肌内注射配合米非司酮25 mg治疗,2次/d,口服3 d,随访直至临床结局。分析成功与失败患者TVCD的特点和血清HCG的水平。结果:TVCD能直接反映胚胎生命力,不同TVCD图像和血清HCG水平的患者,保守治疗成功率有很大差异,50例患者经保守治疗成功45例,成功率为90%;经TVCD检查血流分级为0级、Ⅰ级、Ⅱ级患者保守治疗成功率均为100.00%,血流分级为Ⅲ级患者保守治疗成功率为44.44%;血清HCG水平<1 000 mIU/ml患者保守治疗成功率为100.0%,血清HCG水平为1 000～2 000 mIU/ml及>2 000 mIU/m患者保守治疗成功率为83.3%和62.5%。结论:TVCD及血清HCG水平的检查可用于适合保守治疗异位妊娠的筛选,对于异位妊娠包块血流分级为Ⅲ级,结合血清HCG>1 000 mIU/ml的患者,保守治疗失败率高,不推荐药物保守治疗。
Objective： To explore the clinical value of serum human chorionic gonadotropin（HCG） level and transvaginal color doppler sonography（TVCD） in choosing suitable patients with ectopic pregnancy for conservative treatment.Methods： 50 cases of ectopic pregnancy with vital signs stability were injected with a single dose of 50 mg/m2 Methotrexate（MTX） after TVCD examination,bid 3 d.All patients followed up until clinical results were confirmed.The TVCD imaging characteristics and serum HCG levels were analysed in the failure and success cases.Results： TVCD could reflect the viability of ectopic fetus directly.There was a significant difference in successful rate of medical treatment of ectopic pregnancy among the patients with various types of TVCD images and various levels of serum HCG.45 cases were conservative treatment successfully,with the rate of 90%.The successful rate of conservative treatment patients with TVCD blood flow classification of level 0,Ⅰ,Ⅱwas 100.00%,but the successful rate of conservative treatment patients with TVCD blood flow classification of level Ⅲ was 44.44%.The successful rate of conservative treatment patients with serum HCG level1 000 mIU/ml was 100.0%,but the successful rate of conservative treatment patients with serum HCG level of 1 000-2 000 mIU/ml and 2 000 mIU/ml were 83.3% and 62.5%.Conclusion： TVCD and serum HCG level can be used in screening of conservative treatment in patients with ectopic pregnancy.The patients with TVCD blood flow classification of level Ⅲ and serum HCG level 1 000 mIU/ml have the high failure rate of conservative treatment,thus medical treatment of ectopic pregnancy is not recommended to them.
出处
《中国医药导报》
CAS
2011年第29期96-98,共3页
China Medical Herald
