The Effect Of Different Treatments For Tubal Pregnancy On Prognosis-analysis Of519Cases

Objective: To investigate the effects of different methods in the treatment of tubalpregnancy on prognosis, and provide basis of clinical options.Methods:519cases with tube pregnancy who treated in the First AffiliatedHospital of Dalian Medical University from2007January to2011December wereretrospectively analyzed, according to the different patterns of initial treatment weredivided into three groups: Group A:Salpingotomy group(157cases); Group B:Salpingectomy group (177cases); Group C: Methotrexate group(185cases).Results: Salpingotomy group in age,gravidity were significantly higher than theother two groups, there were significant differences. There were not significantlydifferent between two operation groups in the serum β–HCG before treatment andhemoperitoneum.When the serum β–HCG<2000mIU/ml before treatment, the successrate of60.3%with single application of MTX was higher than the rate of11.5%withoperation treatment; Otherwise, when the serum β–HCG≥2000mIU/ml beforetreatment,the rate of operation therapy for41.2%was higher than the success rate withsingle or repeated methotrexate.Comparison of two operation groups: Shock patientsafter salpingectomy groups accounted for35.6%, while the salpingotomy groupaccounted for24.8%, there were significant differences. Tubal rupture cases aftersalpingectomy groups accounted for49.7%, the salpingotomy group accounted for only36.3%, the salpingotomy group was significantly lower than that in salpingectomygroup. Operation time between the two groups, the salpingotomy group wassignificantly longer than the salpingectomy group. Salpingectomy group wassignificantly more than salpingotomy group in the bleeding volume. The ratio of serumβ–HCG after operation treatment and before operation treatment, to observe the changesof serum β–HCG. the salpingotomy group:the first1-2days0.3420±0.15496; the5-7days0.0609±0.07790; the salpingectomy group the first1-2days0.4639±0.64768; the 5-7days0.0488±0.07422; methotrexate group the first1-2days0.7591±0.53527the5-7days0.4028±0.35918.Compare with the other two groups, serum β–HCGdecreased more slowly in application of MTX. Failure of salpingotomy group(diagnosis for persistent ectopic pregnancy) is3cases (2%), methotrexate group is37cases (20%) of treatment failure, salpingectomy group were all cured.The three groupsafter treatment to pregnancy, intrauterine pregnancy, ectopic pregnancy, infertility againno significant difference.Conclusion: The serum β-HCG≥2000mIU/ml before treattment and whetheror not hemoperitoneum are on the main influencing factors of MTX treatmentsuccess.In terms of three kinds of different treatment methods for subsequentreproduction, There was no difference among the three groups in the rate of intrauterinepregnancy, tubal ectopic pregnancy, and secondary infertility.