输卵管妊娠后再次妊娠的探讨

Fecundify after treatment of tubal pregnancy

对输卵管妊娠后有生育要求的５８例行输卵管切除术（切除组），１５例行输卵管开窗术（开窗组），３０例应用药物保守治疗（药物组）。结果：１０３例治疗后６７例宫内妊娠，９例再次异位妊娠。切除组及开窗组宫内妊娠５２例，妊娠率（７１．２％）高于药物组（５０．０％），开窗组妊娠率（８６．７％）高于切除组（６７．２％），且无一例再次异位妊娠。同时，随机选择治疗后３～６个月的４５例行输卵管通畅检查，开窗组双侧输卵管通畅率为９３．３％，药物组为２０．０％。提示：输卵管通畅是妊娠的良好条件，术后预防粘连、积极治疗盆腔炎是提高宫内妊娠率减少异位妊娠的重要环节。

his study is a follow-up analysis of 103 patients who desired to preserve their fertile ability after treatment of tubal pregnancy; Among the 103 cases, 58 were treated by unilateral salpingectomy,15 bysalpingostomy and 30 by drug conservative therapy.Results:67 cases had intrauterine pregnancy and 9cases repeated ectopic pregnancy. The intrauterine pregnancy rate of the surgical group(71.2%)was higher than that of the nonsurgical group(50.0%).And the pregnancy rate of salpingostomy group(86.7%)was higher than that of salpingectomy group (67.2%).No repeated ectopic pregnancy oc-curred in the salpingostomy group.After three rnonths of treatment, 45 cases were randomly sampled for tubal patency test;Bilateraltubal patency rate in salpingostomy group was 93.3%and in drug treat-ment group was 20.0%. These results indicated that tubal patency is an essential factor for normal pregnancy,Prevention of post-operative adhesion and treatment of pelvic inflammatory disease are im-portant for increasing intrauterine pregnancy rate and decreasing repeated ectopic pregnancy rate.