中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2015年
3期
612-614
,共3页
输卵管切除术%人绒毛膜促性腺激素%持续性异位妊娠%甲氨蝶呤%米非司酮
輸卵管切除術%人絨毛膜促性腺激素%持續性異位妊娠%甲氨蝶呤%米非司酮
수란관절제술%인융모막촉성선격소%지속성이위임신%갑안접령%미비사동
salpingectomy%human chorionic gonadotropin ( hCG)%persistent ectopic pregnancy ( PEP)%MTX%mifepristone
目的：探讨输卵管妊娠根治术后持续性异位妊娠的原因及诊治。方法分析2003年1月1日至2014年9月30日杭州师范大学附属医院输卵管妊娠根治术后发生的6例持续性异位妊娠病例的诊疗过程。结果输卵管妊娠根治术后持续性异位妊娠病例占同期输卵管妊娠根治病例的1.6%。患者平均年龄(27.4±5.7)岁,平均停经时间(45.3±6.7)天；6例均为流产型或破裂型；术前血人绒毛膜促性腺激素(hCG)平均(10476.2±13874.3) IU/L,术后3天血 hCG 降幅平均为(79.7%±17.9%),血hCG最低平均(493.1±891.4)IU/L,再次上升的时间平均为术后(18.5±5.9)天；6例中有4例单用甲氨蝶呤(MTX)药物治疗,另2例MTX联合米非司酮治疗,两种治疗方法均治愈患者,疗效上无显著性差异(t=0.298,P>0.05)。结论输卵管妊娠根治术后持续性异位妊娠的发生与术前血hCG的高低、输卵管妊娠的类型、手术方式等相关,术后严密监测血hCG非常必要。
目的：探討輸卵管妊娠根治術後持續性異位妊娠的原因及診治。方法分析2003年1月1日至2014年9月30日杭州師範大學附屬醫院輸卵管妊娠根治術後髮生的6例持續性異位妊娠病例的診療過程。結果輸卵管妊娠根治術後持續性異位妊娠病例佔同期輸卵管妊娠根治病例的1.6%。患者平均年齡(27.4±5.7)歲,平均停經時間(45.3±6.7)天；6例均為流產型或破裂型；術前血人絨毛膜促性腺激素(hCG)平均(10476.2±13874.3) IU/L,術後3天血 hCG 降幅平均為(79.7%±17.9%),血hCG最低平均(493.1±891.4)IU/L,再次上升的時間平均為術後(18.5±5.9)天；6例中有4例單用甲氨蝶呤(MTX)藥物治療,另2例MTX聯閤米非司酮治療,兩種治療方法均治愈患者,療效上無顯著性差異(t=0.298,P>0.05)。結論輸卵管妊娠根治術後持續性異位妊娠的髮生與術前血hCG的高低、輸卵管妊娠的類型、手術方式等相關,術後嚴密鑑測血hCG非常必要。
목적：탐토수란관임신근치술후지속성이위임신적원인급진치。방법분석2003년1월1일지2014년9월30일항주사범대학부속의원수란관임신근치술후발생적6례지속성이위임신병례적진료과정。결과수란관임신근치술후지속성이위임신병례점동기수란관임신근치병례적1.6%。환자평균년령(27.4±5.7)세,평균정경시간(45.3±6.7)천；6례균위유산형혹파렬형；술전혈인융모막촉성선격소(hCG)평균(10476.2±13874.3) IU/L,술후3천혈 hCG 강폭평균위(79.7%±17.9%),혈hCG최저평균(493.1±891.4)IU/L,재차상승적시간평균위술후(18.5±5.9)천；6례중유4례단용갑안접령(MTX)약물치료,령2례MTX연합미비사동치료,량충치료방법균치유환자,료효상무현저성차이(t=0.298,P>0.05)。결론수란관임신근치술후지속성이위임신적발생여술전혈hCG적고저、수란관임신적류형、수술방식등상관,술후엄밀감측혈hCG비상필요。
Objective To investigate the causes and treatment of persistent ectopic pregnancy ( PEP ) after salpingectomy for tubal pregnancy. Methods Analysis was conducted on the clinical data of 6 cases with PEP after salpingectomy for tubal pregnancy at the Affiliated Hospital of Hangzhou Normal University from January 1st,2003 to September 30th,2014 . Results The cases with PEP accounted for 1. 6% of those with salpingectomy for tubal pregnancy. Mean age of these 6 patients was 27. 4 ± 5. 7years old, and the mean amenorrhea duration was 45. 3 ± 6. 7days. All of the cases were rupture type or abortion type. Mean level of human chorionic gonadotropin (hCG) before salpingectomy was 10 476. 2 ± 13 874. 3IU/L, and the average decreasing amplitude was 79. 7% ± 17. 9% at 3 days after surgery. The lowest mean level of hCG was 493. 1 ± 891. 4IU/L, and its rising occurred 18. 5 ± 5. 9days after surgery. Four of 6 cases were treated with MTX, and the other 2 were given MTX and mifepristone. Both therapies were effective and there was no significant difference between them. Conclusion The level of hCG, type of tubal pregnancy and surgery method are associated with PEP after salpingectomy for tubal pregnancy, so much attention should be paid on monitoring hCG after salpingectomy.
