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目的:对异位妊娠患者治疗前临床评分,旨在筛选适合药物保守治疗的异位妊娠患者。方法:118例患者接受甲氨喋呤(MTX)50 mg/m2单次肌肉注射,配合米非司酮片150 mg顿服,同时口服中药宫外孕汤,随访临床结局。以孕周、血β-HCG值、孕酮值、包块大小为评分指标,以总评分为6、7、8、9四个分值为界,对不同评分下异位妊娠保守治疗成功的敏感性、特异性、阳性预测值、阴性预测值进行了分析。结果:异位妊娠患者行药物保守治疗者占34%(52/444)。当四项评分总值≤9时,药物保守治疗成功率92%,失败率只有8%,阴性预测值50%,而>9分时,药物保守治疗成功率只有50%。结论:综合多项指标,我们认为以四项评分≤9为保守治疗最佳指征,>9分者推荐手术治疗。
Objective: To evaluate the clinical score of patients with ectopic pregnancy before treatment, aimed at screening patients with ectopic pregnancy suitable for conservative treatment. Methods: A total of 118 patients received a single intramuscular injection of methotrexate (MTX) 50 mg / m2 and mifepristone 150 mg once daily. Ectopic pregnancy was also given orally. Clinical outcomes were followed up. Pregnancy, blood β-HCG value, progesterone value, mass size as a scoring index to the total score of 6,7,8,9 four scores for the community, under different scores of conservative treatment of ectopic pregnancy success Sensitivity, specificity, positive predictive value, negative predictive value were analyzed. Results: Conservative treatment of ectopic pregnancy patients accounted for 34% (52/444). When the total score of four scores is less than 9, the success rate of drug conservative treatment is 92%, the failure rate is only 8%, and the negative predictive value is 50%. When the score is> 9, the conservative treatment success rate is only 50%. Conclusion: Based on a number of indicators, we consider the best indication of conservative treatment with four scores ≤9, and more than 9 recommend surgery.