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 persistent ectopic pregnancy after the salpingocyesis conservative surgery

目的探讨输卵管妊娠保守性手术治疗后，发生持续性异位妊娠（PEP）的相关影响因素。方法回顾性分析378例输卵管妊娠保守性手术治疗患者的临床资料，其中腹腔镜手术（腹腔镜组）213例，开腹手术（开腹组）165例。结果发生PEP6例，腹腔镜组PEP的发生等适为0．94％，开腹组PEP的发生率为2．42％，两组比较差异无统计学意义（P〉0．05）。PEP的发生与孕龄大小、术后HCG下降幅度、病理滋养叶细胞增生程度、术后甲氨蝶呤（MTX）预防性应用有关（P〈0．05），与术前HCG水平无相关性。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，预防性使用MTX，术后严密监测血清HCG变化，对于降低PEP的发生尤为重要。

Objective To discuss the relevant factors about the persistent ectopic pregnancy（PEP） which occurs after conservative surgery of oviduct pregrtancy. Methods The clinic data of 378 patients who accepted the conservative surgery of oviduct pregnancy from January 2002 to June 2006 were analyzed retrospectively. There into 213 cases were celioscope conservative surgery （celioscope group）, 165 cases were traditions surgery（traditional group ）. Results The PEP possibility in the eehoscope group was 0.94%, and 2.42% in the traditional group, altogether 6 cases. There was no significanl difference between the two groups （P 〉0.05）. The occurrence of PEP was related to the pregnancy age, the decrease of serum HCG after surgery and the preventative application of MTX after surgery （P 〈 0.05 ）. There was no relation to the dosage of serum HCG before surgery. Conclusions The celioscope traditional surgery is safe and effective to the oviduct pregnancy. Strictly controlling the surgery comphcations, improving the surgery skill,rigorously examing the change of serum HCG after surgery and preventative using of MTX are critical to reduce the possibility of PEP.