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Điều trị nguyên bào nuôi tồn tại sau mổ nội soi bảo tồn vòi tử cung trong chửa ngoài tử cung chưa vỡ tại bệnh viện Phụ sản Trung ương

nckh
Thông tin nghiên cứu
Loại tài liệu
Bài báo trên tạp chí khoa học (Journal Article)
Tiêu đề
Điều trị nguyên bào nuôi tồn tại sau mổ nội soi bảo tồn vòi tử cung trong chửa ngoài tử cung chưa vỡ tại bệnh viện Phụ sản Trung ương
Tác giả
Vũ Văn Du
Năm xuất bản
2012
Số tạp chí
12
Trang bắt đầu
60-62
ISSN
1859-1663
Abstract

Objectives: To evaluate percentage af persistent trophoblast, how to manage when has persistent trophoblast and to dertermine the complication of laparoscopic procedure in hospital. Design: uncontrolled clinical trials. Methods: The inclusion criteria for treatment: hemodynamic stability, BetahCG levels less than 20.000 mUI/ml, and adnexal mass of 6 cm or less in diameter and the patients desire for a future pregnancy and the patients consent to participate in the study obtained through a signed document approved by the institutional ethical committee. Salpingostomy was performed by incising the antimesenteric side of the fallopian tube with electrocautery without the use of vasopressin. Product of conception were removed by hydrodissection. Preoperative BetahCG levels were obtained as close to the time of surgery as possible. Serial serum BetahCG concentrations were obtained until the BetahCG concentration was 5 mlU/ml. Results: The results demonstrating a 6 percent treatment failure rate agree with these reported. Level of BetahCG immediately before initial suregy ranged from 555 - 4388 mIU/ml. Levels of BetahCG after the initial suregy but immediately before the second treatment ranged from 88 - 514 mIU/ml. The interval between initial salpingotomy and repeat treatment ranged from 4 - 22days. The 6 women with persistent trophoblast treated successfully methotraxate. There is no patients presented clinical symptom. Multivariate logistic regression analysis included the following variable: duration of suregy, surgical technique, history of previous ectopic pregnancy,history of previous lower abdominal suregy. None of variables were predictive of persistent trophoblast. Conclusion: Percentage of persistent trophoblast was 6 percent. The all women with persistent trophoblast treated successfully methotraxate. There is no patients presented clinical symptom. The study shows that there were no postoperative complication or returns to theatre.