Abstract：Objective: To explore the effects of conservative medication, open surgery and laparoscopic surgery on patients with ectopic pregnancy. Methods: The clinical data of 80 patients with ectopic pregnancy admitted to the hospital from March 2016 to March 2019 were retrospectively analyzed. According to different treatment methods, they were divided into conservative medication group (mifepristone + methotrexate + Shapei prescription, 30 cases), open group (openfallopian tube resection, 30 cases) and laparoscopic group (laparoscopic fallopian tube resection, 20 cases). At 1 week after treatment, the levels of serum β-human chorionic gonadotropin (β-hCG), progesterone (P) and vascular endothelial growth factor (VEGF) were compared among the three groups, and the clinical efficacy was evaluated by serum indexes and imaging results. The adverse reactions or complications were monitored in the three groups after treatment. The hospital stay and hospitalization expense were compared among the three groups. At 3 months after treatment, the psychological states of the patients were evaluated by Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS), and the sexual function was evaluated by Female Sexual Function Index (FSFI). Results: At 1 week after treatment, the levels of serum β-hCG, P and VEGF in open group and laparoscopic group were significantly lower than those in conservative medication group (P<0.05), but there were no significant differences between open group and laparoscopic group (P>0.05). The efficacy was 100.00% in open group and laparoscopic group, which was significantly higher than that in conservative medication group with 63.33% (P<0.05). There were no significant differences in the incidence rates of adverse reactions or complications among the three groups (P>0.05). The hospital stay in conservative medication group was significantly longer than that in open group and laparoscopic group (P<0.05), and the hospitalization expense was significantly lower than that in open group and laparoscopic group (P<0.05). At 3 months after treatment, the reductions of SAS and SDS scores in conservative medication group were greater than those in open group (P<0.05) while the decrease of FSFI score was smaller than that in open group (P<0.05), but there were no significant differences compared with those in laparoscopic group (P>0.05). Conclusion: Surgical treatment of patients with ectopic pregnancy can improve serum β-hCG, P and VEGF faster, and its early efficacy is better than conservative treatment, but conservative treatment is superior to surgical treatment in hospitalization expense and psychological states and sexual function status after treatment. And surgical treatment medication have better safety, and it is necessary to take individualized treatment by combining with the actual situation in clinical practice.
李凡, 王如萍, 周萍. 不同治疗方案对异位妊娠患者血清β-hCG P及VEGF的影响及安全性[J]. 河北医学, 2020, 26(7): 1092-1096.
LI Fan, WANG Ruping, ZHOU Ping. The Effects and Safety of Different Treatments on Serum β-hCG P and VEGF in Patients with Ectopic Pregnancy. HeBei Med, 2020, 26(7): 1092-1096.
[1] 王洪玲,张琰.早期异位妊娠患者β-HCG、E2和P水平变化及预测分析[J].现代预防医学,2019,46(1):64~67. [2] 罗书,黄勇,关红琼.米非司酮联合甲氨蝶呤在异位妊娠治疗中的效果和安全性观察[J].中国性科学,2018,27(5):97~99. [3] 赖筱琍,李恩辉,祁锋.中西医结合三联疗法对异位妊娠保守治疗后输卵管通畅度的影响[J].中华中医药学刊,2017,35(6):1601~1603. [4] 王玉东,周赟.早期异位妊娠快速诊断新方法[J].中国实用妇科与产科杂志,2017,33(9):881~884. [5] Bizjak I,Fiala,Christian,Berggren,Linus,et al.Efficacy and safety of very early medical termination of pregnancy:a cohort study[J].Bjog An International Journal of Obstetrics & Gynaecology,2017,124(13):1993~1999. [6] Koch M,Schwab,Stephanie,Meyer,Elias,et al.Management of uterine ectopic pregnancy - local versus systemic methotrexate[J].Acta Obstetricia Et Gynecologica Scandinavica,2018,97(7):824~829. [7] 尹红章,万淑琼.中西医结合治疗异位妊娠的临床观察[J].时珍国医国药,2018,29(9):161~162. [8] 郑华,张雁,郭宏霞.不同治疗方案对异位妊娠所保留输卵管形态及功能影响的研究[J].中国计划生育和妇产科,2017,9(1):51~54. [9] Snyman L,Makulana T,Makin J D.A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy[J].South African Medical Journal,2017,107(3):258~263. [10] 王雪梅,李瑞琴,马欢,等.米非司酮联合甲氨蝶呤与腹腔镜手术治疗异位妊娠的疗效比较[J].实用临床医药杂志,2018,22(19):94~96. [11] 张芬,刘奋琴,毕雪玲,等.宫外孕保守治疗和手术切除输卵管对女性性功能的影响对比分析[J].中国性科学,2017,26(10):113~115.
2020, Vol. 26 
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