3种不同方式治疗输卵管妊娠疗效分析

Analysis of Therapeutic Effects of Three Different Treatments to Tubal Pregnancy

目的:探讨输卵管妊娠的合理治疗方案。方法:回顾性分析输卵管妊娠住院治疗病例,按保守性药物、保守性手术及根治性手术3种不同治疗手段分组,比较治疗后输卵管通畅率、宫内妊娠率、再次异位妊娠率。结果:药物组与保守性手术组输卵管通畅率分别为55·3%和94·9%,差异具有非常显著性。宫内妊娠率依次为保守性手术组66·4%,药物组50·0%,根治性手术组48·3%。三者再次异位妊娠率差异无显著性。结论:对于输卵管妊娠的治疗,根治性手术适合包块较大且对侧输卵管正常者,年轻且有生育要求者应慎用;药物治疗具有无创伤性和费用低廉,但较保守性手术输卵管通畅率、术后妊娠率及宫内妊娠率低,治疗随访周期长。

Objective：To investigate the rational therapeutic protocol in treatment of tubal pregnancy.Methods： The cases hospitalized for tubal pregnancy were reviewed and were divided to three groups according to therapeutic method, conservative medicine therapy, conservative surgery and radical surgery. After the treatment, re,oration of oviduct, intrauterine pregnancy, and subsequent fertility ware compared. Results：The patent rate of fallopian tube was 55.3% and 94.9% in medicine therapy group and conservative surgery group separately, the difference was statistically significant. Intrauterine pregnant rate was 66.4%, 50.0%, and 48.3% in conservative surgery, medicine therapy, and radical surgery, respectively, which significant difference among three groups. Recurrent ectopic pregnant rate among three groups was no statistically significant. Conclusions： Radical surgery is suitable for with bulky lesion and normal lateral tube, which destroyed the integrity of reproductive tract and must be careful to apply with young women whom hope to preserve fertility. Medicine therapy has no trauma and cheap, but the followup is Iong, failure rate is higher and it has some influence on tubal obstruction.