| BackgroundEctopic Pregnancy(EP)is not only a kind of common and frequently encountered disease but also a acute abdomen in the department of gynaecology and obstetrics.If we don't deal with it in time or it once break suddenly can cause the big issue of blood wait serious complications occurrence,even endanger the sufferer's life.The occurrence rate of EP in reports at home and abroad is rising in recent years.With the people's consciousness for health protection rise and the technical progress of diagnosis and treatment,above eighty percent patients can be made a diagnosis in ordor to lay a good foundation for it can be cured in early days and for a choice of therapic method,so this could provide a condition for the conservative treatment of EP.But in the process of diagnosis and treatment of early ectopic pregnancy,the index is the dynamic observing of β - HCG and lump with Color Doppler ultrasound.The long-term clinical study proves that it's value is restrict. Therefore,looking for a kind of more value and higher accuracy monitoring index sign for the choice for treatment method of EP,monitoring the conservative treatment of EP in early days and estimate the prognosis and termination of conservative treatment of earlier EP become a hot point in the existing study of EP.The domestic and foreign scholars has the research detection that they have their specificity and sensibility to combine monitoring blood flow display with color Doppler ultrasound with monitoring of β - HCG and PROG and the methods take their effect.But the research that their action in the conservative treatment of earlier EP was still little.Therefore, the study for combination of monitoring becomes a hot point in the existing study of EP.Moreover,it appears fairly stringent. ObjectiveTo observe the appearance and variety regularity by monitoring of the PSV,EDV,RI with Color Doppler ultrasound and determination of the conservative β - HCG,PROG in the drug treatment of early ectopic pregnancy and to approach the relationship between them and the effect of drug treatment for EP.Accordingly,we can look for a simple,fast,sensitive and specific method of the choice for treatment method and the monitoring in the drug treatment of early EP.And then,it hope to become a effective index for follow-up and monitoring and be used for an estimate the prognosis and termination of earlier EP,in order to raise the achievement ratio in drug treatment of earlier EP,to be be used for monitoring the effect of drug treatment and an estimate the prognosis and termination of earlier EP,and then consummate the follow-up indexes. MethodsResearch object:From October 2005 to March 2007, serum samples of the out-patient service examined a patient in early days and accept a hospitalization or the out-patient service didn't examine a patient to accept a hospitalization definitely temporary to examine a patient further and definitely behind were collected and done the medicine cure at the planned parenthood comprehensive section of Shandong Provincial Hospital.There were 76 cases that meet the above criteria altogether.They were divided into two groups.the A group is a drug treatment group (46 cases) and the B group is a operation group (30 cases) .First make a conclusive diagnosis and then give the A group a medicine treatment.It should be determined PSV,EDV,RI with transonogram and β-HCG,PROG. Give the B group a treatment of operation and it should be determined PSV,EDV,RI with transonogram and β-HCG,PROG before the treatment. The color Doppler is made in GE company of American. It's pattern number is Voluson730Pro.The installation of instrument is a vaginal transonogram checking program.First,to display the two-dimensional pictures of uterus and appendix clearly using two-dimensional and conventional way to sweep.Then,to determine the value of PSV,EDV and RI with the color Doppler in the appendix.Finally,to make a ultraphonic diagnosis.The blood samples of PROG and β-HCG were determined by automatic electrochemiluminescence analyzer.The data was analyzed by SPSS 11.5 for windows statistical package.Data of normal distribution were described with mean.The comparison of the difference of means of two groups was processed by Student's t-test.It meant significant if P<0.05. Results1.There was no significant difference on age,height,weight,gravidity,abortion times,menelipsis weeks,menstrual cycle between the two groups(P>0.05). (table 1)2.The distinctive appearance and variety regularity of PSV,EDV,RI and |3 -HCG,PROG in the process of drug treatment before and after being given medicine treatment:(1)The value of PSV,EDV,RI and β-HCG,PROG were 30.47±19.75,12.37±11.81,0.59±0.11,1868.44±2033.64,4.09±3.02 before given medicine treatment in the drug treatment group. We could arrive at a conclusion that the distinctive appearance of blood flow display for EP patients is a kind of typical,low and spectral resistance blood frequency characteristic.I.e.It is circum-trophoblastic blood.(graph 6)(2)From the first to the fourth rechecked value of PSV,EDV,RI and β-HCG,PROG were 29.86±16.07cm/s ～ 4.94±11.89cm/s,10.16±4.65cm/s ～ 1.45±3.19cm/s,1851.95±1445.57mIU/ml ～ 36.09±42.34mIU/ml,2.50±1.88ng/ml ～ 2.55±3.05ng/ml;0.66±0.18～0.97±0.09(table 3)after given medicine treatment in the succeed drug treatment group.We could arrive at a conclusion that in the therapic cycle increased progressively,the RI of the blood is increased to land the signal of the blood(PSV,EDV)is weaken to zero gradually with the constant variance of β-HCG,PROG are decreased.That is to say, the relationship between the variance of β-HCG,PROG and PSV,EDV is positive correlation.the relationship between the variance of β-HCG,PROG and RI is negative correlation.(3)Through comparing the metered results and the analysis in statistics of PSV,EDV,RI and β-HCG,PROG in the drug treatment group before and after being given medicine treatment:We could arrive at a conclusion that there were significant difference between the value of before being given medicine treatment and the first rechecked value(P<0.05)except the PSV,EDV in the two groups(P>0.05)by the table 4.1.We could arrive at a conclusion that there were significant difference between the value of before being given medicine treatment and the second, third and fourth rechecked value (P<0.05) by the table 4.2,4.3 and 4.4.3.The distinctive variety regularity for combination of monitoring:the circum-trophoblastic blood in the appendix of EP patients after given medicine treatment in the succeed drug treatment group takes on distinctive variance with the constant variance of β-HCG,PROG.In the 46 cases for drug treatment(table 5):(1)There are 28 cases their value of β-HCG and PROG is decreased obviously,the value of RI is increased and the value of PSV,EDV is shrink gradually.Their drug treatment were all succeed and the achievement ratio is 100%. (2)There are 12 cases their value of β-HCG and PROG is invariant or with modicus variance,the value of RI is increased and the value of PSV,EDV is shrink gradually.After given drug treatment, among them 9 cases were succeed,3 cases were failed and the achievement ratio is 75%.(3)There are 6 cases their value of β-HCG and PROG is increased,the value of RI is decreased and the value of PSV,EDV is increased on the contrary.After given drug treatment,among them 2 cases were succeed,4 cases were failed and the achievement ratio is 33.33%.4.Through comparing the metered results and the analysis in statistics of PSV,EDV,RI and β-HCG,PROG before treatment in the drug treatment group and the operation group:There were significant difference between the two groups(P<0.05)except the PSV and EDV in the two groups(P>0.05).5.Estimate the prognosis and termination:The sensibility and specificity of the solitary and conjoined monitoring of PSV,EDV,RI and p-HCG,PROG that used to estimate the prognosis and termination of earlier EP were(table 7).Based on them, we could arrive at a conclusion that the sensibility and specificity of conjoined monitoring of PSV,EDV,RI and β-HCG,PROG are more higher than the solitary monitoring in estimate the prognosis and termination of earlier EP. Conclusions1 .The distinctive appearance a of PSV,EDV,RI before being given medicine treatmentlt is a kind of typical,low and spectral resistance blood frequency characteristic.It is monophasic or diphase, persistent exist,it's frequency spectrum is widen and the blood in diastolic phase is affluent.I.e.It is circum-trophoblastic blood.2.In the therapic cycle increased progressively,the RI of the blood is increased to land the signal of the blood(PSV,EDV)is weaken to zero gradually with the constant variance of β-HCG,PROG are decreased.That is to say, the relationship between the variance of β-HCG,PROG and PSV,EDV is positive correlation, the relationship between the variance of β-HCG,PROG and RI is negative correlation.3.The distinctive variety regularity for combination of monitoring and the significance:the circum-trophoblastic blood in the appendix of EP patients after given medicine treatment in the succeed drug treatment group takes on distinctive variance with the constant variance of β-HCG,PROG.(1)If the value of β-HCG and PROG is decreased obviously,the value of RI is increased and the value of PSV,EDV is shrink gradually,drug treatment were mainly succeed.(2)If the value of β-HCG and PROG is invariant or with modicus variance,the value of RI is increased and the value of PSV,EDV is shrink gradually,the possibility of successful drug treatment is biggish and they could be kept going to be geiven drug treatment under the rigorous monitoring.(3)If the value of β-HCG and PROG is increased, the value of RI is decreased and the value of PSV,EDV is increased on the contrary,the possibility of successful drug treatment is min.They were unsuitable for being geiven drug treatment and should be carried on a operation as soon as possible.4.In estimate the prognosis and termination of earlier EP, the sensibility and specificity of conjoined monitoring of PSV,EDV,RI and β-HCG,PROG are 84.78 % ,93.33 % .they are more higher than the solitary monitoring.The conjoined monitoring of PSV,EDV,RI and β-HCG,PROG is a convenience,fast,atraumatic,the sensitivity and specificity higher monitor method.It provid alternations of the treatment method for earlier EP that based on it.It also produces a marked effect in estimating the curative of medicine treatment,prognosis and follow-up.Then it hope to become a good index for follow-up and monitoring and be used for an estimate the prognosis and termination of earlier EP.Therefore,the conjoined monitoring of PSV,EDV,RI and β-HCG,PROG have important value and clinical meaning in medicine treatment of earlier EP.
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