Retrospective Analysis Of Factors Affecting Tubal Pregnancy Conservative Treatment With Integrated Traditional Chinese And Western Medicine

Objective:Through retrospective analysis of tubal pregnancy cases in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine in the past 10 years,the factors affecting the conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine were discussed,the treatment rules were summarized,and relevant experience and treatment options for tubal pregnancy patients were provided.Reference materials to better guide clinical work.Materials and Methods:A retrospective analysis of the clinical data of 404 cases of patients who were admitted to our hospital for conservative treatment with integrated traditional Chinese and Western medicine from January 2011 to December 2020 was conducted.The patients were divided into conservative treatment group and operation group according to their information,including 374 cases in the conservative treatment group and 30 cases in the operation group.Record the patient’s information in detail,including general conditions(age,menopausal days),past medical history(pregnancy times,cesarean section history and times,abortion history and times,ectopic pregnancy history and times,abdominal surgery history and times,menstrual disorders),TCM syndrome type,onset season,auxiliary examination(blood β-HCG value,B-ultrasound display mass diameter and depth of pelvic effusion),treatment status,etc.Result:1.In univariate analysis,the patient’s age,number of days of menopause,times of pregnancy,history and frequency of miscarriage,history and frequency of cesarean section,history and frequency of abdominal surgery,history of ectopic pregnancy,onset season,TCM syndrome,B-ultrasound showed initial mass Diameter and depth of initial pelvic effusion are not factors that affect the conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine(P>0.05),but the number of patients’ previous ectopic pregnancy and initial blood β-HCG value are the factors(P<0.05).2.Multivariate logistic regression analysis showed that the initial blood β-HCG value is a factor that affects the conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine(P<0.001).And when other factors are fixed,the initial bloodβ-HCG value increases by one level(including the three levels of <500IU/L,500-1000IU/L,>1000IU/L),the probability of conservative treatment switching to surgery is the previous 4.080 times the first level(95% CI: 2.316-7.187).3.The success rates of conservative treatment with initial blood β-HCG levels >500IU/L and >1000IU/L were 85.71% and 80.34% respectively;between 0-500 IU/L,501-1000IU/L,1001-2000 IU/L.The conservative treatment success rates were 98.20%,95.38%,94.64%,and the cumulative success rates were 98.20%,97.56%,and 97.08%.4.After 7 days of conservative treatment,the blood β-HCG value of 81.59% of patients decreased,and 92.10% of patients had a decrease of blood β-HCG value after 14 days of treatment.About 80% of patients’ blood β-HCG value dropped by more than half after 10-14 days of treatment,and 47.11% of patients’ blood β-HCG value dropped by more than 90%after 14 days of treatment.5.The length of hospital stay of patients who were converted to surgery after conservative treatment was less than that of patients who continued conservative treatment(P<0.05).For patients who continue conservative treatment,the initial blood β-HCG value and conservative treatment time(ie hospitalization time)have a significant weak positive correlation(P=0.000<0.01 is a significant correlation,0<Rs=0.286<0.4 is a weak positive correlation).6.Through ROC curve analysis,it was shown that the blood β-HCG cut-off values at the initial and fourth days were 2116.43IU/L and 825.08IU/L,respectively.The sensitivity at this time was 66.70% and 86.70%,and the specificity was 89.80% and 78.90.%,the success rate of initial blood β-HCG value<2116.3IU/L was 97.10%,and the success rate of blood β-HCG value<825.08IU/L on day 4 was 98.68%.Comparing the blood β-HCG value of the initial and the 4th day,when the blood β-HCG value on the 4th day of treatment is lower than the initial blood β-HCG <5.99%,it can predict the failure of conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine,and vice v ersa.Predict the success of the treatment.7.In the conservative treatment group,the blood β-HCG value decreased the fastest in 0-4 days,followed by 10-14 days.The data of the conservative treatment group is further subdivided,and patients whose blood β-HCG value changes during admission have a continuous downward trend are divided into the descending group,and patients whose bloodβ-HCG value changes first rise and then fall are divided into the peak group.It is concluded that in the descending group,the blood β-HCG value decreased the fastest in 0-4 days,followed by 7-10 days.The blood β-HCG value decreased group can drop to more than 50%of the peak value on the 4th day,and can drop to more than 90% of the peak value on the14 th day.The peak type group reached its peak on the 7th day,and the increase in blood β-HCG was about 50% of the initial value.The decline was the fastest in 10-14 days,and it dropped to more than 50% of the peak on the 14 th day.The day can drop to more than 90%of the peak value.The length of hospital stay in the descending group was significantly shorter than that in the peak group,which was statistically significant(P<0.01).In Conclusion:1.The patient’s initial blood β-HCG value significantly affected the conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine(P<0.001),and when other factors were fixed,the initial blood β-HCG value increased by one level(including < 500IU/L,500IU/L,500IU/L).-1000IU/L and >1000IU/L),the probability of conservative treatment switching to surgery is 4.080 times of the previous grade(95% CI: 2.316-7.187).2.Through ROC curve analysis,it is concluded that when conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine,the initial blood β-HCG level is lower than 2116.43 IU/L,and the blood β-HCG level on the fourth day of treatment without the contraindications of other conservative treatments.Lower than 825.08IU/L,it is a better choice for conservative treatment with integrated traditional Chinese and western medicine.3.Through ROC curve analysis,when the blood β-HCG value on the 4th day of treatment decreases less than 5.99% compared with the initial blood β-HCG,the failure of conservative treatment of tubal pregnancy with integrated traditional Chinese and western medicine can be predicted.On the contrary,the success of the treatment can be predicted.