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目的:观察宫腔外生化妊娠与临床异位妊娠保守治疗的临床效果。方法:对平时月经周期规律、停经≤49天的妇女,依据停经天数、阴道流血、腹痛、β-HCG水平及阴道B超结果分为宫腔外生化妊娠(G1)组和临床异位妊娠(G2)组各100例。给予米非司酮25mg,每天2次,连用3~5天;MTX肌肉注射第1天40 mg、第2~5天20 mg。治疗过程中及(或)治疗结束后复查血清β-HCG及B超了解治疗效果。结果:G1组一疗程治愈66例,两疗程治愈23例,失败6例,治疗过程中B超发现宫内出现孕囊行人工流产5例。G2组一疗程治愈38例,两疗程治愈31例,治疗过程中患者放弃保守治疗改行手术治疗13例,失败18例。两组比较,G1组治愈率(93.68%,89/95)明显高于G2组(79.31%,69?87)(P<0.05)。结论:宫腔外生化妊娠行保守治疗疗效确切,效果明显高于临床异位妊娠。所以对疑为宫腔外生化妊娠的非意愿性妊娠者不必等待至发展为临床异位妊娠再做处理。
Objective: To observe the clinical effect of conservative treatment of uterine biochemical pregnancy and clinical ectopic pregnancy. Methods: According to the regular menstrual cycle, women with menopause ≤ 49 days were divided into two groups based on the number of menopause, vaginal bleeding, abdominal pain, β-HCG level and vaginal ultrasonography (G1) group and clinical ectopic pregnancy G2) group of 100 cases. Given mifepristone 25mg, 2 times a day, once every 3 to 5 days; MTX intramuscular injection of 40 mg on day 1, 2 to 5 days 20 mg. During the course of treatment and / or after treatment, serum β-HCG and B-ultrasound were used to understand the therapeutic effect. Results: In group G1, 66 cases were cured by one course of treatment, 23 cases were cured by two courses and 6 cases failed. During the course of treatment, intrauterine abortion occurred in 5 cases. In group G2, 38 cases were cured with one course of treatment, and 31 cases were cured with two courses. In the course of treatment, 13 patients were given conservative treatment instead of surgical operation, and 18 patients failed. The cure rate of G1 group (93.68%, 89/95) was significantly higher than that of G2 group (79.31%, 69.87) (P <0.05). Conclusion: The conservative treatment of uterine biochemical pregnancy is effective and the effect is obviously higher than that of clinical ectopic pregnancy. Therefore, the suspected uterine biochemical pregnancy involuntary pregnancy do not have to wait until the development of clinical ectopic pregnancy and then do the treatment.