血β-HCG浓度与宫外孕药物保守治疗的关系

目的探讨宫外孕药物保守治疗的指征及方案。方法选取115例宫外孕住院患者，根据血β-人绒毛膜促性腺激素（β-HCG）浓度不同分3组，A组β-HCG≤5000U／L予氨甲喋呤（MTX）＋米非司酮；B组β-HCG5000～8000U／L及C组β-HCG〉8000U／L予MTX＋米非司酮＋5-氟尿嘧啶（5-FU）药物治疗，对其治疗效果及不良反应进行分析研究。结果①115例患者，成功107例，失败8例，总治愈率93.04％，无一例严重不良反应；②β-HCG≤5000U／L96例，成功91例，成功率94．79％，β-HCG〉5000U／L 19例，成功16例，成功率84．21％，二者比较P〈0．05，差异有统计学意义；③B组β例，成功12例，成功率92．31％；C组6例，成功4例，成功率66．67％，B、C组比较均P〈0．05，差异有统计学意义，A、B组比较P〉0．05，差异无统计学意义。结论本研究显示宫外孕药物保守治疗效果满意，其指征可适当放宽至β-HCG≤5000U／L，并应根据β-HCG值、B超检查等综合考虑选择不同药物治疗方案。

The Relation of β-HCG Concentration and Conservative Treatment with Drug of Ectopic Pregnancy

Objective To discuss the indication and regimen of conservative treatment in patients with ectopic pregnancy. Methods 115 patients with ectopic pregnancy were classified into 3 groups according to the level of β-HCG in serum. MTX and mifeprestone was administrated to the first group, MTX and mifeprestone combinated 5-FU was administrated to the others, each group was analyzed in its curative and side effect. Result A. 108 of 115 cases were healed, 7 of them were failed. The gross cure rate is 93. 04%. B. The group which β-HCG is under 5000 U/L showed higher curative rates than thoseβ-HCG is over 5 000 U/L（ P 〈 0.05 ） . C. Group B showed higher curative rates than group C （ P 〈 0.05 ） , group A and B didn＇ t have significant differences in curative rates （ P 〉 0.05 ）. Conclusion The conservative treatment with drug for ectopic pregnancy in this study is efficient,especially, in the group of β-HCG under 5000 U/L. So, it is necessary to properly select the indication of conservative treatment for patients with ectopic pregnancy, and treatment regimen according to the change of β-HCG in serum and result of ultrasound detection.