输卵管妊娠的综合介入治疗研究
发布时间：2018-12-27 12:02
【摘要】：目的：探讨综合介入治疗输卵管妊娠的临床疗效和意义。 方法：回顾性分析2009年12月-2013年12月在武汉科技大学附属天佑医院和湖北省妇幼保健院收治的输卵管妊娠患者104例，，自愿接受综合介入治疗52例的作为研究组，接受药物肌肉注射治疗的52例作为对照组。比较两组患者的平均年龄、停经时间、治疗前血β-HCG值和盆腔包块直径；观察治疗中动脉造影的形态特征；比较治疗后两组的治愈率、血β-HCG值降至正常的时间、盆腔包块吸收的时间、月经恢复正常的时间、不良反应发生率；分别监测研究组术前、术后三个月、术后六个月E2、LH、FSH水平有无变化；月经恢复正常干净后第三天做HSG，观察两组输卵管通畅情况。对结果进行统计学分析。 结果：1.两组患者的平均年龄、停经时间、治疗前血β-HCG值和盆腔包块直径比较均无统计学差异(P0.05)，两组资料具有可比性。 2.研究组子宫动脉造影根据其形态大致可分为两种类型：类型一无明显征象，类型二实质期可见小片状绒毛染色。 3.研究组治愈率为96.15%，血β-HCG值降至正常为17.60±6.29天，盆腔包块吸收时间为26.98±6.23天，月经恢复正常的时间为32.64±4.88天，不良反应发生率为6.00%；对照组治愈率为76.92%，血β-HCG值降至正常为22.75±7.91天，盆腔包块吸收时间为30.30±8.23天，月经恢复正常的时间为34.58±5.82天，不良反应发生率为27.50%。经统计学分析，两组治愈率(P0.01)、血β-HCG值降至正常时间(P0.01)、盆腔包块吸收时间(P0.05)、不良反应发生率(P0.01)差异有统计学意义,两组月经恢复正常时间(P0.05)差异无统计学意义。 4.比较研究组术前、术后三个月、术后六个月E2、LH、FSH，差异无统计学意义(P0.05)。 5.研究组和对照组治疗后输卵管通畅率分别为92.50%和76.32%，差异有统计学意义(P0.05)。 结论：1、在TP的治疗中，综合介入治疗比单剂量药物治疗疗效好，恢复快，不良反应少，优势明显。 2、子宫动脉造影在TP诊疗中有较高的诊疗价值，可与B超检查和血β-HCG的测定优势互补，对准确诊断定位和预测治疗效果有重要意义。 3、综合介入治疗能有效避免和减少TP破裂出血，最大限度的保持输卵管的完整。 4、运用综合介入治疗TP对卵巢功能无明显影响。 5、综合介入治疗是一种微创、精准、安全、有效的治疗TP的方法。
[Abstract]:Objective: to explore the clinical effect and significance of comprehensive interventional therapy for tubal pregnancy. Methods: 104 cases of tubal pregnancy treated in Tianyou Hospital of Wuhan University of Science and Technology and Hubei Provincial Maternal and Child Health Hospital from December 2009 to December 2013 were retrospectively analyzed. 52 patients received intramuscular drug injection as control group. The mean age, menopause time, blood 尾-HCG value and pelvic mass diameter were compared between the two groups, and the morphologic features of arteriography were observed. The cure rate, serum 尾-HCG value, the time of pelvic mass absorption, the time of menorrhagia returning to normal, and the incidence of adverse reactions were compared between the two groups after treatment. The changes of E2LHH FSH were observed before operation, 3 months after operation and 6 months after operation, and the oviduct patency of the two groups was observed by HSG, on the third day after menstruation returned to normal and clean. The results were analyzed statistically. Results: 1. There was no significant difference in mean age, menopause time, blood 尾-HCG value and pelvic mass diameter between the two groups (P0.05). 2. Uterine arteriography in the study group can be divided into two types according to its morphology: type 1, no obvious signs, type 2 substantial phase of small chorionic villi staining. 3. In the study group, the cure rate was 96.15, the 尾-HCG value of blood decreased to normal 17.60 卤6.29 days, the absorption time of pelvic mass was 26.98 卤6.23 days, the time of menstruation returning to normal was 32.64 卤4.88 days, and the incidence of adverse reaction was 6.00; In the control group, the cure rate was 76.92, the 尾-HCG value of blood decreased to normal 22.75 卤7.91 days, the absorption time of pelvic mass was 30.30 卤8.23 days, the time of menstruation returning to normal was 34.58 卤5.82 days, and the incidence of adverse reaction was 27.50. By statistical analysis, the cure rate (P0.01), blood 尾-HCG value decreased to normal time (P0.01), pelvic mass absorption time (P0.05), incidence of adverse reactions (P0.01) were significantly different between the two groups. There was no significant difference in menstrual recovery time between the two groups (P0.05). 4. There was no significant difference between the study group and the study group before operation, 3 months after operation and 6 months after operation (P 0.05). 5. The rate of tubal patency was 92.50% in the study group and 76.32% in the control group (P0.05). Conclusion: 1. In the treatment of TP, the comprehensive interventional therapy is better than the single dose drug treatment, the recovery is faster, the adverse reaction is less, the superiority is obvious. 2. Uterine arteriography has high value in diagnosis and treatment of TP. It can complement the advantages of B-ultrasound examination and determination of blood 尾-HCG, and has important significance for accurate diagnosis, localization and prediction of therapeutic effect. 3. Comprehensive interventional therapy can effectively prevent and reduce the bleeding of TP rupture and keep the tubal intact to the maximum extent. 4. Comprehensive interventional therapy (TP) had no significant effect on ovarian function. 5. Comprehensive interventional therapy is a minimally invasive, accurate, safe and effective method for the treatment of TP.
【学位授予单位】：武汉科技大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.221
本文编号：2393031
[Abstract]:Objective: to explore the clinical effect and significance of comprehensive interventional therapy for tubal pregnancy. Methods: 104 cases of tubal pregnancy treated in Tianyou Hospital of Wuhan University of Science and Technology and Hubei Provincial Maternal and Child Health Hospital from December 2009 to December 2013 were retrospectively analyzed. 52 patients received intramuscular drug injection as control group. The mean age, menopause time, blood 尾-HCG value and pelvic mass diameter were compared between the two groups, and the morphologic features of arteriography were observed. The cure rate, serum 尾-HCG value, the time of pelvic mass absorption, the time of menorrhagia returning to normal, and the incidence of adverse reactions were compared between the two groups after treatment. The changes of E2LHH FSH were observed before operation, 3 months after operation and 6 months after operation, and the oviduct patency of the two groups was observed by HSG, on the third day after menstruation returned to normal and clean. The results were analyzed statistically. Results: 1. There was no significant difference in mean age, menopause time, blood 尾-HCG value and pelvic mass diameter between the two groups (P0.05). 2. Uterine arteriography in the study group can be divided into two types according to its morphology: type 1, no obvious signs, type 2 substantial phase of small chorionic villi staining. 3. In the study group, the cure rate was 96.15, the 尾-HCG value of blood decreased to normal 17.60 卤6.29 days, the absorption time of pelvic mass was 26.98 卤6.23 days, the time of menstruation returning to normal was 32.64 卤4.88 days, and the incidence of adverse reaction was 6.00; In the control group, the cure rate was 76.92, the 尾-HCG value of blood decreased to normal 22.75 卤7.91 days, the absorption time of pelvic mass was 30.30 卤8.23 days, the time of menstruation returning to normal was 34.58 卤5.82 days, and the incidence of adverse reaction was 27.50. By statistical analysis, the cure rate (P0.01), blood 尾-HCG value decreased to normal time (P0.01), pelvic mass absorption time (P0.05), incidence of adverse reactions (P0.01) were significantly different between the two groups. There was no significant difference in menstrual recovery time between the two groups (P0.05). 4. There was no significant difference between the study group and the study group before operation, 3 months after operation and 6 months after operation (P 0.05). 5. The rate of tubal patency was 92.50% in the study group and 76.32% in the control group (P0.05). Conclusion: 1. In the treatment of TP, the comprehensive interventional therapy is better than the single dose drug treatment, the recovery is faster, the adverse reaction is less, the superiority is obvious. 2. Uterine arteriography has high value in diagnosis and treatment of TP. It can complement the advantages of B-ultrasound examination and determination of blood 尾-HCG, and has important significance for accurate diagnosis, localization and prediction of therapeutic effect. 3. Comprehensive interventional therapy can effectively prevent and reduce the bleeding of TP rupture and keep the tubal intact to the maximum extent. 4. Comprehensive interventional therapy (TP) had no significant effect on ovarian function. 5. Comprehensive interventional therapy is a minimally invasive, accurate, safe and effective method for the treatment of TP.
【学位授予单位】：武汉科技大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.221
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