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目的观察β-人绒毛膜促性腺激素(β-h CG)、孕酮用于监测输卵管妊娠保守治疗中的变化情况,探讨各观察指标与治疗效果的相关性和输卵管妊娠保守治疗的预测指标。方法选择异位妊娠病例120例,不限制血清β-h CG值、孕酮值,排除出血性休克者均予药物保守治疗。统一药物保守治疗方案,甲氨蝶呤20 mg肌肉注射,每天1次,连续5 d;随机选择联合米非司酮(米非司酮25 mg口服,每天2次,共3 d)、复方米非司酮(米非司酮30 mg+双炔失碳酯5 mg口服,每天1次,共2 d)及单纯使用甲氨蝶呤。治疗第1、4、7、11、14天分别用化学发光法检测血清β-h CG值、孕酮值。结果β-h CG值最能反映治疗结局及住院天数的预测性;第4~7天孕酮变化较孕酮第1~4天的变化更有意义。结论动态观察β-h CG值、孕酮能加强异位妊娠结果的预测。
Objective To observe the changes ofβ-hCG and progesterone in the conservative treatment of tubal pregnancy, and to explore the correlation between each observation index and the therapeutic effect and the predictive value of conservative treatment of tubal pregnancy. Methods 120 cases of ectopic pregnancy were selected, without limiting the serum β-h CG value, progesterone value, excluding hemorrhagic shock were treated with conservative drugs. Unified drug conservative treatment regimen, methotrexate 20 mg intramuscularly, once a day for 5 consecutive days; random selection combined with mifepristone (mifepristone 25 mg orally twice daily for 3 d) Nimesulide (mifepristone 30 mg + anordrin 5 mg orally, once daily for 2 days) and methotrexate alone. On the 1st, 4th, 7th, 11th and 14th day of treatment, the serum β-h CG value and progesterone value were respectively detected by chemiluminescence method. Results The β-h CG value can best reflect the prognosis of the treatment outcome and hospitalization days. The changes of progesterone in the 4th to 7th days were more significant than those of the 1st to 4th days of progesterone. Conclusion Dynamic observation of β-h CG value, progesterone can enhance the prediction of ectopic pregnancy results.