异位妊娠诊断的变化及治疗方法的选择

目的:探讨相隔10年异位妊娠诊断的变化及治疗方法的选择。方法:回顾分析我院1995年度及2005年度共151例异位妊娠的诊治情况。结果:①异位妊娠与同期分娩数之比由1995年的1·0∶16·3上升为2005年的1·0∶4·2。②诊断技术有改进,剖腹探查的比例下降,而经阴道超声结合血、尿绒毛膜促性腺激素(β-HCG)检测确诊者增多。确诊时间缩短,1995年平均为(5·6±0·7)天,2005年平均为(3·2±0·2)天,P<0·05。③手术治疗比例下降,保守治疗比例上升,其成功率增加。结论:异位妊娠发生率增高。阴道超声结合敏感的血清β-HCG测定缩短了确诊的时间。剖腹手术减少,腹腔镜手术及保守治疗是目前异位妊娠治疗的趋势。

Study on the changes of diagnosis and the choice of treatment of ectopic pregnancy

Objective:To investigate the changes of diagnosis and treatment of ectopic pregnancy(EP) in 1995 and 2005.Methods:Medical records of 151 cases with EP seen in our hospital in 1995 and 2005 were collected and analyzed retrospectively.Results:①The incidence of EP increased from 1.0 per 16.3 labours in our hospital in 1995 to 1.0 per 4.2 labours in 2005.②Diagnosis was confirmed more by transvaginal ultrasound combined blood and urine of human chorionic gonadotropin-beta assay rather than exploratory laparotomy and with a shorter period. (5.6±0.7)days in 1995 versus (3.2±0.2)days in 2005, P<0.05.③The choice of treatment was more conservative than surgical treatment. The success rate of conservative treatment was increased.Conclusion:Although the incidence of EP is increasing, vaginal ultrasound with sensitive determination of serum β-HCG shorten the diagnosis time. Laparotomy is reduced ,laparoscopic surgery and conservative treatment are the trends of treating ectopic pregnancy .