黄体血流分级对未破裂型输卵管妊娠保守治疗的影响

摘要

Objective:To study the impact of corpus luteum blood classification on conservative treatment of unruptured tubal pregnancy,and provide reference for clinical treatment of the patients.Methods:Clinical data of patients who were diagnosed with unruptured tubal pregnancy and accepted conservative treatment in department of obstetrics and gynecology in the first affiliated hospital of Xi'an Jiaotong university from June 2013 to December 2016 were retrospectively analyzed.Objects were divided into corpus luteum blood level 0 group(31 cases),corpus luteum blood level 1 group (34 cases),corpus luteum blood level 2 group (38 cases),corpus luteum blood level 3 group(29 cases) according to the corpus luteum blood flow classification.The decrease of blood β-HCG,the packet reducing and the curative effect were compared among the four groups.Results:①The β-HCG reduced fastest in incorpus luteum blood level 0 group,which accompanied the shortest time of β-HCG dropped to normal(14.39 ± 2.67 days).Moreover,the diameter of mass shrink fastest in incorpus luteum blood level 0 group,which accompanied the shortest time of mass disappeared entirely(13.30 ±2.24 days).The β-HCG reduced slowest in incorpus luteum blood level 3 group,which accompanied the longest time of β-HCG dropped to normal(27.04 ±4.56 days),and the diameter of mass shrink lowest in incorpus luteum blood level 3 group,which accompanied the longest time of mass disappeared entirely (24.11 ± 3.44 days),there was significant difference among the four groups(P ＜0.05).②Patients incorpus luteum blood level 0 group had the highest curative rate(90.32％),but lowest in luteum blood level 3 group(72.41％),there was significant difference among the four groups(P ＜0.05).③The adverse reactions in all patients included elevated serum transaminase(5 cases),gastrointestinal reaction (9 cases) and drowsiness sleepiness (4 cases),there was no statistically difference among the four groups by Fisher's exact probability test(P ＞ 0.05),and the adverse reactions all disappeared after conservative treatment.Conclusions:The classification of corpus luteum blood may influence the conservative treatment effect of patients with unruptured tubal pregnancy,the higher the blood flow classification,the longer the time needed for treatment,and the poorer of the curative effect.%目的:研究黄体血流分级对于未破裂型输卵管妊娠保守治疗的影响,为患者临床治疗提供参考.方法:回顾性分析2013年6月至2016年12月在西安交通大学第一附属医院妇产科就诊的未破裂型输卵管妊娠保守治疗132例患者的临床资料,根据妊娠黄体的血流分级分为0级组(31例)、1级组(34例)、2级组(38例)、3级组(29例).比较各组患者治疗后血β-人绒毛膜促性腺激素(β-HCG)下降、包块缩小情况及疗效.结果:①黄体血流分级中0级组患者治疗后不同时间点血β-HCG水平均最低、下降至正常所需时间最短(14.39±2.67天),保守治疗后不同时间点包块直径均最小,包块完全消失所需时间最短(13.30±2.24天);3级组患者血β-HCG水平均最高,下降至正常所需时间最长(27.04±4.56天),保守治疗后不同时间点包块直径均最大,包块完全消失所需时间最长(24.11±3.44天),4组闻比较,差异有统计学意义(P＜0.05).②黄体血流分级中0级组患者治疗有效率最高(90.32％),3级组最低(72.41％),4组间比较,差异有统计学意义(P＜0.05).③所有患者中不良反应包括血清转氨酶升高5例、胃肠道反应9例、困乏嗜睡4例,4组间不良反应比较经Fisher确切概率法检验,差异无统计学意义(P＞0.05),保守治疗结束后患者不良反应均消失.结论:黄体血流分级对未破裂型输卵管妊娠保守治疗有影响,血流分级越高,治疗所需时间越长,疗效越差.