【摘要】 目的:探讨血清β-HCG<1 000 U/L的异位妊娠治疗方案及相关影响因素。方法:回顾性分析血清β-HCG<1000 U/L的异位妊娠202例,其中102例采用肌肉注射MTX 50 mg+口服米非司酮150 mg(A组),100例采用期待疗法(B组)。所有病例治疗前测定血清β-HCG并做彩超检查,于第4天和第7天复查β-HCG和B超。结果:A组第4天有29例患者β-HCG上升,但幅度<30%,第7天β-HCG均下降;B组第4天有34例患者β-HCG上升,其中21例患者上升幅度>30%,第7天有17例患者上升超过一倍,这些患者停经时间均<40天,彩超提示包块周围有丰富的彩流信号。包块周边有丰富彩流信号者β-HCG水平相对较高,用杀胚药物治疗后下降幅度较大;少或无彩流信号者用杀胚药治疗后血清β-HCG水平与期待治疗组无明显差别。结论:对于血清β-HCG<1 000 U/L的异位妊娠患者不能一律采用期待疗法,若患者停经时间<40天,彩超提示包块周围有丰富的彩流信号应积极采取杀胚治疗,在治疗过程中第4天β-HCG和B超表现略有加重不能视为治疗无效。更多还原

【Abstract】 Objective:To study the influence of the therapeutic regiments and relating factors in ectopic pregnancy of β-HCG<1 000 U/L.Methods:The retrospective study was carried out 202 cases of ectopic pregnancy of β-HCG<1 000 U/L who were re-monitored by β-HCG and Color Doppler ultrasound in the pretherapy in the forth day and the seventh day.Among the total,the 102 cases were treated by MTX 50mg intramuscular injection and Mifepristone 150mg per so as Group A,the others were expectant treatments as Group B.Results:The β-HCG of 28%(29/102) of the Group A was increased by extent less than 30% in the forth day,however was deceasing for whole Group A in the seventh day.The β-HCG of 34%(34/100) of the Group B was increased in the forth day,by which extent more than 30% for 21%(21/100) of the Group B,however 17%(17/100) of them increased by twice in the seventh day.The gestational time for these patients was less than 40 days,and Color Doppler ultrasound was imaging turbulent blood flow surrounding tissue.The Color Doppler ultrasound showing the marker the blood flow,the higher the density in β-HCG.The treatment of MTX combined Mifepristone was effective.The therapy wasn’t obvious difference between the rare blood flow and the expectant treatment groups.Conclusion:The ectopic pregnancy of β-HCG<1000U/L can’t overall use expectant treatments.The positive therapy with MTX combined Mifepristone should be used in which the gestational weeks of patient is less than 4 weeks and what the blood flow is marker in the Color Doppler ultrasound.It doesn’t seemed ineffective if the density of β-HCG and the blood flow increase a little.更多还原