摘要
目的探讨阴超声结合血清因子水平指标在异位妊娠保守治疗的价值。方法选取120例异位妊娠患者作为研究对象,均接受经阴超声检查及血清指标检测,对异位妊娠患者120例采用甲氨蝶呤联合米非司酮进行保守治疗资料进行回顾性分析。并检测治疗前、治疗中血人绒毛膜促性腺激素(β-HCG)和孕酮的变化对治疗的影响及血β-HCG水平与阴道超声检查包块类型的关系。结果治疗后不同范围血β-HCG值,其成功率差异有统计学意义(P<0.05),β-HCG值<2 000 U/L成功率最高,<5 000 U/L次之;治疗后不同类型的包块成功率差异有统计学意义(P<0.05),不均质包块成功率明显高于孕囊及心管搏动型(P<0.05);不同孕酮水平单次治疗后成功百分比差异显著(P<0.05),孕酮水平越低成功百分比越高;孕酮值与包块类型呈正相关(P<0.05),血流信号各级与β-HCG值呈正相关(P<0.05);治疗中β-HCG值主要呈现持续下降型、骤升骤降型、持续上升型、骤升缓降型不同趋势曲线变化。结论血清β-HCG、孕酮联合阴道超声检查附件包块类型及血流信号分级,是判断异位妊娠保守治疗是否成功的综合指标。
Objective To explore the clinical value of transvaginal ultrasonography combined with serum factor detection in conservative treatment of ectopic pregnancy. Methods A total of 120 patients with ectopic pregnancy who were treated in our hospital from January 2015 to September 2017 were enrolled in the study. All the subjects were examined by transvaginal ultrasonography and serum indexes detection,then the patients with ectopic pregnancy were treated by oral methotrexate and mifepristone,and the clinical data were retrospectively analyzed. The effects of the changes of blood β-HCG and progesterone levels on therapeutic effects and the relationship between the level of blood β-HCG and the type of vaginal ultrasound examination before and during treatment were analyzed. Results There was significant difference in the success rates of serum β-HCG value of different ranges after treatment（ P 〈0. 05）. The success rates at β-HCG 〈2,000 U/L was the highest,followed by β-HCG 〈5 000 U/L. After treatment,there were significant differences in success rates of different types of masses（ P〈 0. 05）. The success rates of inhomogeneity mass were significantly higher than those of gestational sac and cardiac tube. And there was significant difference in percentage of success rates of progesterone after a single treatment（ P〈 0. 05）. The lower the level of progesterone was,the higher percentage of success rates would be. The progesterone values and blood flow signals at different levels were positively correlated with types of mass and β-HCG values,respectively. During treatment,changes of trend curves of β-HCG values in four types（ continuous descending type,sudden ascending and descending type,continuous ascending type,sudden ascending and slow descending type） were observed. Conclusion It is the comprehensive indicator to detect the types of adnexal mass and blood flow signals grading by transvaginal ultrasonography combined with serum levels of β-HCG in evaluating whether conservative treatment of ectopic pregnancy is successful or not.
作者
朱文娜
张婷婷
曹娜
徐俊荣
尹晓燕
ZHU Wenna;ZHANG Tingting;CAO Na(Deparment of UItrasonic Diagnosis,People’s Hospital of Fucheng County,Hebei,Fucheng 053700,China)
出处
《河北医药》
CAS
2018年第10期1459-1463,共5页
Hebei Medical Journal
基金
衡水市重点研发技术项目(编号:2017014019Z)
关键词
阴道超声
孕酮
血清Β-HCG
异位妊娠
transvaginul ultrasound
progesterone
β-HCG
ectopic pregnancy
