输卵管妊娠腹腔镜术后持续性异位妊娠的预防

Prevention of persistent ectopic pregnancy after laparoscopic surgery for tubal pregnancy

目的探讨输卵管妊娠腹腔镜术后持续性异位妊娠(PEP)发生的可能病因及预防措施。方法回顾性分析该院2001年10月～2004年6月异位妊娠腹腔镜手术135例。结果发生PEP2例,发生率为1.48%,均为腹腔镜保守性手术后。结论输卵管妊娠腹腔镜保守性手术后PEP发生可能性大,仔细、彻底清除妊娠组织,术中常规病灶两端输卵管及系膜注入氨甲喋呤(MTX),正确选择保守性手术病例,可以有效避免输卵管妊娠保守性手术后PEP的发生。术后严密监测β-HCG下降情况,及时静脉滴注MTX,可降低PEP的危险。

[Objective ] To explore the possible reasons and prevention measures of persistent ectopic pregnancy （PEP） after laparoscopic surgery for tubal pregnancy. [Methods] A retrospective analysis of 135 cases between Oct.2001 and Jun.2004 ectopic pregnancy after TV laparoscopic surgery in our hospital was performed. [Results] There were two cases of PEP, about 1.48 percent, both of which after conservation laparoscopic surgery. [Conclusions] PEP takes place mostly after the TV lapscopic surgery foe tubal pregnancy, ablating the histiogestation completely,in jecting MTX into the two bottoms of the injured tabe and it may prevent it efficiently, and control the cases of conservative surgery. Measuring the deline of β-HCG and using MTX through ivdrip in time can reduce the danger of PEP.