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目的:探讨异位妊娠不同手术方式治疗后血β-hCG及孕酮(P)的下降规律和临床疗效。方法:对采用不同手术方式(开腹手术及腹腔镜手术、保守性手术及根治性手术)治疗的165例异位妊娠患者的临床资料进行回顾性分析,分析手术治疗后不同时期血β-hCG及P水平的动态变化规律,血清中P及β-hCG采用全自动化学发光免疫分析仪测定。结果:①异位妊娠患者不同手术方式治疗后第1日血hCG及P下降百分比的平均值分别为62.7±11.6%和61.7±17.8%,术后血β-hCG水平降至正常水平的时间平均为13.1±5.3 d。②异位妊娠患者经手术治疗后,血β-hCG下降百分比在术后24 h、48 h、72 h及术后1周存在显著差异,血β-hCG随着术后恢复时间逐渐降至正常(F=408.39,P<0.001),血P下降百分比在术后24 h、48 h、72 h及术后1周也存在显著统计学差异(F=159.04,P<0.001);③血β-hCG及P下降百分比在不同手术方法与术后恢复时间的交互作用分析未见统计学差异。结论:异位妊娠患者手术治疗后血β-hCG、P水平随着时间的推移在术后2周左右逐渐降至正常水平,选择不同手术方式治疗后血β-hCG、P水平恢复至正常水平下降的时间差异无明显统计学意义。对于异位妊娠患者手术方式的选择,应依据患者年龄、生育要求、发病急缓及病情、医院医疗水平等来决定。
Objective: To study the regulation of blood β-hCG and progesterone (P) and the clinical curative effect after different operation methods of ectopic pregnancy. Methods: The clinical data of 165 patients with ectopic pregnancy treated with different surgical methods (laparotomy, laparoscopic surgery, conservative surgery and radical surgery) were retrospectively analyzed. The levels of β-hCG And P levels of dynamic changes in serum P and β-hCG using automated chemiluminescence immunoassay analyzer. Results: ① The mean percentage of hCG and P decreased on the first day after elective pregnancy was 62.7 ± 11.6% and 61.7 ± 17.8%, respectively. The average time of postoperative β-hCG decreased to normal 13.1 ± 5.3 d. ② The percentage of decline of β-hCG in patients with ectopic pregnancy after operation was significantly different at 24 h, 48 h, 72 h and 1 week after operation. The blood β-hCG gradually decreased to normal with the recovery time (F = 408.39, P <0.001). The percentage of decrease of blood P was also significantly different at 24 h, 48 h, 72 h and 1 week after operation (F = 159.04, P <0.001) There was no significant difference in the percentages of hCG and P decline between the different surgical methods and postoperative recovery time. Conclusion: The levels of β-hCG and P in patients with ectopic pregnancy gradually decrease to normal level after 2 weeks of operation, and the levels of β-hCG and P in serum returned to normal after operation There was no significant difference in the time of decline. For patients with ectopic pregnancy choice of surgical approach should be based on patient age, fertility requirements, the incidence of acute and chronic illness and hospital medical level to decide.