| Objective:The diagnosis and treatment outcomes of ectopic pregnancy patients treated with traditional Chinese medicine with fertility requirements in our hospital were summarized,and the related influencing factors were analyzed,so as to provide experience and guidance for future clinical work.Methods:The case data of ectopic pregnancy patients with fertility requirements admitted to the First Hospital of Shanxi Medical University from January 2016 to December 2018 who received conservative treatment with traditional Chinese medicine of ectopic pregnancy I and II and methotrexate combined with mifepristone tablets were selected.Retrospective analysis was conducted,including patients’ age,days of menopause,number of pregnancies,number of abortions,BMI,previous history of ectopic pregnancy,history of pelvic surgery,IUD,blood HCG value,mass size,pelvic effusion,treatment outcome,etc.,and follow-up follow-up for one and a half years was conducted to analyze the outcome of second pregnancy and its influencing factors.Results:1.Group the patients according to their blood HCG levels:< 2000 m IU/ml,2000-2999.9m IU/ml,3000-3999.9m IU/ml,4000-4999.9m IU/ml,5000-9999.9m IU/ml and≥10000 m IU/ml,there was a statistically significant difference in the population distribution between the two groups.Among them,76% of patients in the traditional Chinese medicine group had blood HCG < 5000 m IU/ml,and the number of patients in the western medicine group was roughly the same.2.The conservative success rates of the traditional Chinese medicine groups were 94.52%,100%,80%,100%,61.54%,40%,respectively,and the differences among each group were statistically significant.The conservative success rates of the western medicine groups were 79.49%,63.63%,40%,80%,66.67%,86.67%,respectively,and there was no statistical significance in the difference between the groups.3.Among the 249 patients,196 were conservative successful,with a total success rate of78.71%.In the traditional Chinese medicine group,104 cases were conservative successfully,the success rate was 83.87%.In the western medicine group,92 cases were conserved successfully,with a success rate of 73.60%.4.Blood HCG value(OR=19.933,P < 0.05)and mass size(OR=10.14,P < 0.05)were the main factors affecting the outcome of TCM treatment.The conservative success rates of the TCM groups with mass diameter < 2cm,2-2.9cm,3-3.9cm,4-4.9cm,5-5.9cm and ≥6cm were 90.48%,93.55%,96.97%,57.14%,66.67% and 66.67%,respectively,and there were statistical differences in the success rates among all groups.The conservative success rates of the western medicine group were 64%,74.19%,64.52%,88.89%,83,33% and 80%,respectively,and there was no statistical significance between each group.5.One and a half years after the treatment of 196 patients with conservative success: 123 cases of intrauterine pregnancy,intrauterine pregnancy rate of 62.76%;There were 16 cases of recurrent ectopic pregnancy and 57 cases of infertility.Among them,there were 76 cases of intrauterine pregnancy(73.08%),6 cases of repeated ectopic pregnancy(5.77%),22 cases of infertility(21.15%)in the TCM group.In the western medicine group,there were47 cases of intrauterine pregnancy(51.09%),10 cases of repeated ectopic pregnancy(10.87%),and 35 cases of infertility(38.04%).6.Pelvis effusion(OR=4.811,P < 0.05)was a risk factor for repeated ectopic pregnancy after western medicine treatment.Conclusion:1.For ectopic pregnancy patients with stable vital signs and blood hCG < 2000 m IU/ml and mass diameter < 4cm,traditional Chinese medicine conservative treatment is an effective treatment.2.Most patients with fertility requirements choose conservative drug treatment.3.Traditional Chinese medicine treatment of ectopic pregnancy can have higher intrauterine pregnancy rate,repeat ectopic pregnancy rate and infertility rate is low.4.Pelvic effusion is a risk factor for repeated ectopic pregnancy after western medicine treatment. |
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