ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ CHỬA NGOÀI TỪ CUNG TẠI BỆNH VIỆN QUÂN Y 103

Abstract

Objective: To evaluate the results of ectopic pregnancy treatment at 103 Military Hospital in 2 years (2020-2022). Subjects and methods: A prospective cross-sectional study on 111 patients with ectopic pregnancy were treated at 103 Military Hospital from June 2020 to May 2022. Results: The mean age was 32.68 ± 5.55 years old, from 25-35 years old accounted for 54%, 74.78% of patients were treated by laparoscopic surgery, 27.72% were treated by laparotomy surgery, the rest was medical treatment with methotrexate (MTX) (4.5%). Patients were received 1-3 doses of MTX, 65.22% of patients with 1 dose of MTX. There are 97.73% tubal resection containing the fetal mass and preserving the fallopian tube accounting for 2.27%. The time in surgery is less than 60 minutes, accounting for 84.09%, the mean time of laparotomy surgery is 47.2±3.03 minutes, laparoscopic surgery is 55.73±16.58 minutes. The mean hospital stay was 6.65±2.93 days for MTX treatment, 5±2.12 days for laparotomy surgery, 3.47±0.89 days for laparoscopic surgery. Conclusion: the rate of medical treatment 27.72%, laparotomy surgery 4.5%, laparoscopic surgery 74.78%. Laparoscopic surgery for ectopic pregnancy has the shortest mean hospital stay, the difference with laparotomy surgery and medical treatment is statistically significant. Indications for single-dose medical treatment in cases of unruptured of ectopic pregnancy, no clinical symptoms, ultrasound of fetal mass less than 3.5cm, no embryo, βhCG level in blood less than 3000mUI/ml, success rate with single dose regimen is 100%. Indications for laparoscopic surgery in cases with ectopic pregnancy where medical treatment is no longer indicated, cases of fetal mass rupture with shock have been resuscitated, blood pressure is stable. Indicated for laparotomy surgery in cases with ectopic pregnancy of hemorrhagic shock, hemodynamic instability after intensive resuscitation.