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目的:探讨经阴道彩色多普勒超声联合血β-HCG预测输卵管壶腹部妊娠滋养细胞输卵管浸润的价值,指导输卵管妊娠治疗方式。方法:回顾性分析2008年1月～2011年8月间因输卵管壶腹部妊娠行患侧输卵管切除术患者55例,比较患者术前血β-HCG及输卵管妊娠包块血流信号、血流阻力指数与输卵管滋养细胞浸润程度的关系。结果:55例患者中Ⅱ期输卵管浸润患者明显多于Ⅰ期、Ⅲ期浸润患者(P<0.05)。Ⅰ期输卵管浸润患者血β-HCG为(659.21±623.34)U/L,显著低于Ⅱ、Ⅲ期浸润患者的(2 452.78±1 207.13)U/L和(5 652.78±2 134.56)U/L(P<0.05)。Ⅰ型、高阻血流信号患者多为Ⅰ期输卵管浸润患者,Ⅱ型血流信号多为Ⅱ期浸润患者(P<0.05),Ⅲ型血流信号患者为Ⅱ期、Ⅲ期浸润患者(P>0.05)。Ⅲ型输卵管血流信号患者中,血HCG高于2 500 U/L组多为Ⅲ期输卵管浸润患者,血HCG低于2 500 U/L组多为Ⅱ期浸润患者(P<0.05)。结论:Ⅲ型血流信号或Ⅱ型血流信号,血β-HCG高于2 500 U/L时提示患者Ⅲ期输卵管浸润可能性大,输卵管切除术可能是更为妥当的治疗方式。
Objective: To investigate the value of transvaginal color Doppler ultrasonography combined with blood β-HCG to predict the tubal infiltration of gestational trophoblast in the ampulla of the fallopian tube and to guide the treatment of tubal pregnancy. Methods: From January 2008 to August 2011, 55 patients with tubal amputation due to tubal ampulla pregnancy were retrospectively analyzed. The blood flow resistance, β-HCG and tubal pregnancy mass flow signal Relationship between Index and Tubal Trophoblast Invasion. Results: In 55 cases, the patients with stage Ⅱ tubal infiltration were significantly more than those with stage Ⅰ and Ⅲ infiltration (P <0.05). The level of β-HCG in patients with stage Ⅰ fallopian tube invasion was (659.21 ± 623.34) U / L, which was significantly lower than that of stage Ⅱ and Ⅲ patients (2 452.78 ± 1 207.13) U / L and (5 652.78 ± 2 134.56) U / L (P <0.05). Patients with type Ⅰ and high resistance blood flow were mostly stage Ⅰ tubal infiltrating patients, type Ⅱ blood flow signals were mostly stage Ⅱ infiltrating patients (P <0.05), type Ⅲ blood flow signals were stage Ⅱ and Ⅲ infiltrating patients (P > 0.05). Ⅲ type tubal blood flow signal in patients with blood HCG more than 2 500 U / L group mostly Ⅲ tubal infiltration, blood HCG less than 2 500 U / L group mostly Ⅱ invasion (P 0.05). Conclusion: Type Ⅲ blood flow signal or type Ⅱ blood flow signal, blood β-HCG is higher than 2 500 U / L, suggesting that patients with stage Ⅲ tubal infiltration is likely to tubal resection may be a more appropriate treatment.