输卵管妊娠保守性手术后持续性异位妊娠的相关因素分析

Analysis report for the relevant factors of the salpingocyesis conservative surgery and the persistent ectopic pregnancy

目的探讨输卵管妊娠腹腔镜保守性手术治疗后,发生持续性异位妊娠(PEP)的相关影响因素及预防。方法回顾性分析该院2000年1月￣2004年12月期间,326例输卵管妊娠腹腔镜保守性手术治疗患者的临床资料,并与同期240例输卵管妊娠经腹保守性手术治疗患者的临床资料进行对比分析。结果腹腔镜组持续性异位妊娠的发生率为2.76%,经腹组持续性异位妊娠的发生率为2.50%,两组比较差异无显著性(P<0.05),PEP的发生与孕龄大小、术前血清β-HCG水平、手术者的技能、术后氨甲喋呤(MTX)预防性应用有关。结论腹腔镜保守性手术治疗输卵管妊娠是安全有效的。严格掌握手术适应证,提高手术技巧,术后严密监测血清β-HCG变化,预防性使用MTX,对于降低术后并发症及PEP的发生尤为重要。

[Objective] To discuss the relevant factors and precaution about the persistent ectopic pregnancy （PEP） which occurs after the celioscope conservative surgery of oviduct pregnancy. [Methods] Reviewed and analyzed the clinic data of 556 patients who accepted the conservative surgery of oviduct pregnancy in our hospital from Jan. 2000 to Dec. 2004. Tbereinto, 326 cases were celioscope conservative surgery 240 cases were traditions surgery. [Results] The PEP possibility of the celioscope group was 2.76%, and the conventional group was 2.50%. There is no significant difference between these two groups. The occurrence of PEP is relative to the pregnancy age, the dosage of serum β-HCG before surgery, the skill of operator and the preventative application of MTX after surgery. [Conclusions] The celioscope conservational surgery is safe and effective to the oviduct pregnancy. Strictly controlling the surgery complications, improving the surgery skill, rigorously examining the change of serum β-HCG after surgery and the preventative using of MTX are critical to reduce the surgery complications, especially PEP.