重复异位妊娠50例临床分析

Clinical Analysis of 50 Cases of Repeated Ectopic Pregnancy

目的探讨重复异位妊娠的病因、治疗及预防措施。方法对我院从2002年1月至2006年12月收治的50例重复异位妊娠的临床资料及治疗情况进行回顾性分析。结果 50例重复异位妊娠占同期658例异位妊娠中的7.60%,84.62%输卵管切除者的重复异位妊娠发生在对侧;而保守性治疗者66.67%发生在原患侧,两者间有极显著性差异(P<0.001)。50例重复异位妊娠治疗中8例行药物保守治疗;42例行手术治疗,并经手术病理证实为输卵管妊娠。结论本病的发生与盆腔炎症及前次异位妊娠有关。治疗应根据患者的生育要求,患侧及对侧输卵管的情况等决定,包括输卵管切除术、保守性手术、药物治疗或期待治疗。应积极治疗盆腔炎症,从首次异位妊娠的防治开始来降低重复异位妊娠的发生率。

Objective To explore the causes and treatment and preventive measures of repeated ectopic pregnancy. Methods A retrospective study was conducted on the clinical data of 50 cases of repeated ectopic pregnancy women treated in our hospital from Jan. 2002 to Dec 2006. Results There were 50 cases of repeated ectopic pregnancy amount 658 patients during the same period, the incidence was 7. 60%, With radical resection of the affected fallopian tube,84. 62% of the repeated ectopic pregnancy occurred on contralateral side,while in conservative treatment, it usually occurred on the same side as the original one（66. 67% ）, （ P 〈0. 001 ）. Amount 50 cases of repeated ectopic pregnancy, the were 8 cases with medical conservative treatment and 42 cases with surgery, they were all confirmed tobe tubal pregnancy by operation and pathology. Conclusion The development of repeated ectopic pregnancy was related to pelvic inflammatory disease and the previous ectopic pregnancy. The treatment method should be decided according to patient＇ s reproductive requirement and the affected and contralateral fallopian tube condition, it includes salpingoectomy, conservative operation and medical conservative treatment or awaited treatment, active treatment of the pelvic inflammatory disease and avoiding the first ectopic pregnancy are the important measures for prevention of repeated ectopic pregnancy.