B超-CA125-β-HCG在诊治异位妊娠中探究.docVIP

B超\CA125\β-HCG在诊治异位妊娠中探究[摘要] 目的 通过检测相应时段妊娠相关指标血绒毛膜促性腺激素(β-HCG)、CA125以及B超检测,为临床选择合适的治疗方法提供依据,并最大限度保留患者生育能力。方法 采血、分离血清,检测β- HCG、CA125,每72小时复查一次。固定医生在相应时段用B超检查盆腔情况。结果 研究发现CA125、β-HCG值低的异位妊娠患者保守治疗成功的可能性大,B超包块大小与MTX治疗结局无关。结论 β- HCG、CA125以及B超监测指标在诊断与治疗选择上各有其特点,联合应用可增强其指导作用。 [关键词] 异位妊娠; β-HCG; CA125; B超 [中图分类号] R714.22 [文献标识码] A [文章编号] 1673-9701(2010)09-39-02 B-type Ultrasonography,CA125 and β-HCG in Diagnosis and Treatment in Ectopic Pregnancy XU Feng YAN Yuhong CHEN Wenshu CHEN Xinxiao Obstetrics and Gynecology,Wenzhou Second People’s Hospital,Wenzhou 325000,China [Abstract] ObjectiveTo offer evidence for clinical treatment and reserve patients’ fertility ability maximatily by analyzing relative indicative indexes of pregnancy such as β-human chorionic gonadotrophin(β-HCG),cancer antigen125(CA125) and B-type ultrasonography. MethodsSerum was taken and the levels of β- HCG and CA125 were detected and rechecked once every 72h,and the pelvic condition was examined by B-type ultrasonography. ResultsThe conservative treatment of ectopic pregnancy showed a higher success rate when the CA125 and β-HCG levels were lower. There was no correlation between the size of the ectopic mass and the outcome of MTX treatment. Conclusion β-HCG,CA125 and B-type ultrasonography have their own characteristics in the selection of diagnosis and treatment of ectopic pregnancy,and therefore,the combined use of the three shows a better guidance. [Key words]Ectopic pregnancy; β-human chorionic gonadotrophin; Cancer antigen125; B-type ultrasonography 近年来异位妊娠的发病率有明显上升趋势,而且在未生育者中的比率明显上升,因此对保守治疗要求越来越高。随着辅助治疗技术提高以及医患双方对异位妊娠的警惕性提高,绝大多数异位妊娠已能在早期作出诊断,因此及早进行保守性治疗,可避免手术切除输卵管,最大限度保全患者的生育功能。但药物保守治疗失败、输卵管破裂改为手术切除病例也不少。而腹腔镜下保守性手术后可能出现持续性异位妊娠。因此,异位妊娠早期诊断前提下是首选药物保守治疗,还是腹腔镜下保守性手术,目前尚无客观有效的评价指标。本文通过对716例异位妊娠患者诊治进行分析,探讨如何选择合适的异位妊娠保守治疗方法。 1 资料与方法 1.1 病例选择 从2002年1月～2008年12月7年间我院收治的异位妊娠患者716例,手术患者共388例,其中破裂型163例,流产型225例,药物治疗358例,药物保守治疗成功328例。异位妊娠诊断标准参照《妇产科学》[1]。异位妊娠保守治疗成功的328例为保守治疗组,另一组为手