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目的探讨异位妊娠保守治疗及手术治疗的界限区分方法。方法对我院收治的81例药物治疗的输卵管异位妊娠患者的临床资料进行回顾性分析,观察β-HCG值变化,并监测彩超,确定通过β-HCG来判断输卵管异位妊娠是否需要首先考虑手术治疗。结果 A组(β-HCG<1000U/L):20例成功18例,成功率为90.0%;B组(1000U/L>β-HCG<2000U/L):23例成功21例,成功率为91.3%;C组(2000U/L>β-HCG<3000U/L):18例成功16例,成功率为88.9%;D组(β-HCG>3000U/L):20例成功15例,成功率为75%;其保守失败患者采取手术治疗,均安全出院。结论甲氨蝶呤(MTX)和米非司酮联合治疗效果输卵管异位妊娠疗较为理想,对于早期发现,包块未破且β-HCG<3000U/L时临床成功率较高,对于未婚及有生育要求的女性推广使用。
Objective To explore the method of distinction between conservative treatment and surgical treatment of ectopic pregnancy. Methods The clinical data of 81 patients with tubal ectopic pregnancy who were treated in our hospital were retrospectively analyzed. The changes of β-HCG value were observed, and the color Doppler ultrasound was monitored. To determine whether tubal ectopic pregnancy needs to be considered by β-HCG Surgical treatment. Results Group A (β-HCG <1000U / L): 20 cases were successful in 18 cases, the success rate was 90.0%; Group B (1000U / L> β-HCG <2000U / L) 91 cases in group C (2000U / L> β-HCG <3000U / L): 18 cases succeeded in 16 cases, the success rate was 88.9%; Group D (β-HCG> 3000U / L) The rate was 75%; conservative defeat patients to take surgical treatment, were safely discharged. Conclusions MTX combined with mifepristone is an ideal treatment for tubal ectopic pregnancy. For early detection, the clinical success rate is high when the mass is not broken and β-HCG is less than 3000U / L. For unmarried and Women who have childbearing requirements are promoted to use.