重复异位妊娠32例分析

Analysis of 32 Cases of Repeat Ectopic Pregnant Women

目的分析引起重复异位妊娠的相关因素,探讨重复异位妊娠的治疗及预防措施。方法采用回顾性临床研究方法,对32例重复异位妊娠患者的临床资料进行回顾性分析。结果发现重复异位妊娠的病因主要为盆腔炎症及输卵管病变,占81.3%,无盆腔炎、无输卵管炎比有盆腔炎、有输卵管炎差异有统计学意义(P<0.01)。21例为异侧输卵管妊娠65.6%,11例同侧输卵管妊娠34.4%,2例为输卵管残端妊娠。22例手术治疗,10例保守治疗。本组32例重复异位妊娠,宫内足月妊娠6例,占18.8%。结论积极彻底治疗盆腔病变,对首次异位妊娠选择适合的治疗方法或术式,可改善输卵管妊娠后生殖状况。对重复异位妊娠者应根据手术时患侧输卵管的病变范围、对侧输卵管情况及患者对生育的迫切态度而定,尽可能作保守性手术或保守治疗,以后仍可得足月妊娠。

Objective To analyze the risk factors which contribute to repeat ectopic pregnancy, and to discuss the treatment and prevention about repeat ectopic pregnancy. Method 32 cases of repeat ectopic pregnancy were retrospectively analyzed. Result 81.3% of repeat ectopic pregnancy had pelvic inflammation and pathological changes of fallopian tube. 11 cases （34.4%） had repeat ectopic pregnancy in the same fallopian tube. 22 cases received surgical treatment, and 10 cases received conventional nonsurgical treatment. Conclusion Controlling pelvic inflammation, proper management in the first pregnancy, and improving the conditions of fallopian tube after first pregnancy may reduce the incidence of repeat ectopic pregnancy.