Title:

ANALYSIS OF 37 CASES OF REPEAT ECTOPIC PREGNANCY AFTER CONSERVATIVE THERAPY FOR UNRUPTURED TUBAL PREGNANCY

作者：

宁杨

宁杨

Author(s):

NING Yang.

NING Yang.

单位:

武汉市中心医院妇产科，武汉，430014

Unit:

Department of Obstetrics and Gynecology，Wuhan Central Hospital，Wuhan 430014，China

关键词:

输卵管妊娠; 重复异位妊娠; 危险因素; 保守治疗

输卵管妊娠；重复异位妊娠；危险因素；保守治疗

Keywords:

Unruptured tubal pregnancy; Repeat ectopic pregnancy; Risk factors; Conservative therapy

分类号:

R714.22

文献标识码:

A

摘要:

［ 目的 ］探讨未破型输卵管妊娠保守治疗后，重复异位妊娠的危险因素及3种不同保守治疗方式对重复异位妊娠的影响。［ 方法 ］回顾分析2002年1月~2009年1月某院诊断为未破型输卵管妊娠患者198例，分别采用单纯MTX化疗、开放手术及腹腔镜手术3种保守治疗方式治疗成功，追踪其生育结局12~72个月，根据生育结局分为重复异位妊娠组和宫内妊娠组，根据治疗方式分为MTX组，开放组和腹腔镜组。［ 结果 ］① 37例（18.7%）患者发生重复异位妊娠，其中MTX化疗后17例，开放手术后12例，腹腔镜手术后8例。② 异位妊娠组中存在不良孕产史、盆腔感染、盆腔粘连的患者分别占91.9%、91.9%和75.8%。③ 3种治疗方式异位妊娠发生率分别为 16.8%、37.5%和12.3%，其中药物治疗组和腹腔镜手术组均与开放手术组差异有统计学意义，药物治疗组与腹腔镜组手术组之间差异无统计学意义。［ 结论 ］输卵管炎史、不良孕产史、盆腔粘连等因素可增加重复异位妊娠的发生，未破裂型输卵管妊娠可行药物治疗或腹腔镜下保守性手术作为保留生育功能患者的首选治疗方式，且不增加重复异位妊振的发生率。

Abstract:

［Objective］To explore the risk factors of repeat ectopic pregnancy after conservative therapy for unruptured tubal pregnancy and the effect of three conservative therapies on repeat ectopic pregnancy.［Methods］We retrospectively analyzed 198 patients diagnosed as unruptured tubal pregnancy from Jan. 2002 to Jan. 2009，who got successful treatment respectively by MTX chemotherapy，open surgery and laparoscopic surgery. They were divided into repeat ectopic pregnancy group and uterine pregnancy group according to outcomes which were followed for 12-72 months. They were divided into MTX treatment group，open surgery group and laparoscopic surgery group according to the treatment.［Results］①37 cases（18.7%）suffered from repeat ectopic pregnancy，in which 17 cases were in MTX treatment group，12 cases in open surgery group and 8 cases in laparoscopic surgery group. ②The incidences of the history of abnormal pregnancy，pelvic infection and pelvic adhesion in ectopic pregnancy group were respectively 91.9%，91.9% and 75.8%.③The incidences of ectopic pregnancy in three treatment groups were respectively 16.8%，37.5% and 12.3%. Compared to open surgery group，there was a significant difference both in MTX treatment group and laparoscopic surgery group，but there was no significant difference between MTX treatment group and laparoscopic surgery group.［Conclusion］History of abnormal pregnancy，salpingitis and pelvic adhesion can increase the occurrence of repeat ectopic pregnancy. Chemotherapy or laparoscopic conservative surgery can be the preferred treatment for unruptured tubal pregnancy，which won’t increase the occurrence of repeat ectopic pregnancy.

参考文献
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备注/Memo:

宁杨（1978-），女，医学学士，医师，研究方向：妇科肿瘤