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目的探讨通过检测血清孕酮(P)、血绒毛膜促性腺激素(β-h CG)诊断异位妊娠,并分析其指导治疗方法选择的临床价值。方法以该院收集的128例异位妊娠患者作为异位妊娠组,同期年龄等基础资料相似的60例正常妊娠妇女作为对照组,比较两组妇女妊娠第4~7周时的P、β-h CG水平;以P是否≥15.9 nmol/L作为分层标准,将异位妊娠患者分为P≥15.9 nmol/L(48例)、P<15.9 nmol/L(80例),两组患者均首先给予药物保守治疗,治疗失败患者采用腹腔镜手术治疗。结果正常妊娠组妇女的血β-h CG水平在第4+周、5+周、6+周及7+周时均显著地高于异位妊娠组患者且差异均具有统计学意义(P<0.05)。正常妊娠组妇女的血P值水平在第4+周、5+周、6+周及7+周时均显著地高于异位妊娠组患者且差异均具有统计学意义(P<0.05)。异位妊娠组患者中P≥15.9 nmol/L妇女的包块1~2周内缩小率(58.33%)、症状1~2周内消失率(54.17%)、4周治疗成功率(60.42%)均显著地低于P<15.9 nmol/L的患者,同时治疗1周后β-h CG(1604.8±618.3)U/L、治疗1周后P(10.9±2.4)nmol、治疗失败率(39.58%)均显著地高于P<15.9nmol/L的患者且差异均具有统计学意义(P<0.05)。保守药物失败的27例患者均采用手术治疗成功。结论异位妊娠患者的P、β-h CG水平与正常妊娠妇女有显著的差别,可以进行早期异位妊娠的诊断,同时,对于P≥15.9 nmol/L的异位妊娠患者应注意监测药物治疗效果,及时、尽早地进行手术治疗,保证患者安全。
Objective To investigate the clinical value of detecting progesterone (P) and serum human chorionic gonadotropin (β-h CG) in the diagnosis of ectopic pregnancy. Methods A total of 128 patients with ectopic pregnancy collected from the hospital were used as control group. The control group included 60 pregnant women with similar basic data, such as age, h CG levels.With P 15.9 nmol / L as the stratification criterion, the ectopic pregnancy patients were divided into P≥15.9 nmol / L (48 cases) and P <15.9 nmol / L (80 cases) The first to give conservative treatment of drugs, failure of patients treated with laparoscopic surgery. Results The level of β-h CG in women with normal pregnancy was significantly higher than that in ectopic pregnancy at 4+, 5+, 6+, and 7+ weeks (P <0.05) . The blood P level of women in normal pregnancy group was significantly higher than that in ectopic pregnancy group at the 4th week, 5th week, 6th week and 7th week (P <0.05). In the patients with P≥15.9 nmol / L, the shrinkage rate within 1 ~ 2 weeks (58.33%), the disappearance rate within 1 ~ 2 weeks (54.17%) and the success rate after 4 weeks (60.42%) were significantly higher in ectopic pregnancy group (P <0.05), and the P value was significantly lower than those in P <15.9 nmol / L group (P < ) Were significantly higher than P <15.9nmol / L patients and the differences were statistically significant (P <0.05). Twenty-seven patients who failed conservative treatment were successfully treated surgically. Conclusion The levels of P and β-h CG in patients with ectopic pregnancy are significantly different from those in normal pregnant women and can be used for the diagnosis of early ectopic pregnancy. Meanwhile, patients with ectopic pregnancy with P≥15.9 nmol / L should pay attention to the monitoring of drug therapy Effect, timely and early surgical treatment to ensure patient safety.