不同保守治疗方法对输卵管妊娠后受孕能力的影响

The influence of varying conservative treatment on the gestational ability after tubal pregnancy

目的：评价输卵管妊娠不同保守治疗方法治疗后的生育能力。方法：选择2000年4月~2004年6月间在我院住院有生育要求的输卵管妊娠212例,其中15例行期待疗法,65例行药物保守治疗,92例行剖腹输卵管保守性手术,40例行腹腔镜下输卵管修补术。比较四组1年内及1年后的宫内妊娠率及再次输卵管妊娠率、继发不孕率。所有病例随诊2~4年。结果：1年内保守性手术组尤其是腔镜组术后妊娠率高,未增加重复异位妊娠率,且腔镜组受孕快。1年后四组各项比较差异无显著性。结论：异位妊娠发病率正在逐渐增加,早期诊断的提高增加了保留输卵管功能的机会,使保守性手术及药物治疗更多用于临床。治疗方法存在多样性,保守性手术尤其是腔镜手术对提高妇女的生育力起了一个重大作用,对于希望早日怀孕的妇女有不可取代的优势,而对于有生育要求但短期不想受孕的妇女应根据病情及需要采用不同的治疗方法。

Objective. To evaluate the fertility of varying conservative treatment after tubal pregnancy. Methods： 212 tubal pregnancy patients who were in our hospital from 4, 2000 to 6, 2004 and had childbearing requirement were divided into four groups ： group A （15 cases） was made the temporization, group B （65 cases ） was drug conservative treatment, group C （92 cases ） was laparo -salpingian - conservative - operation, group D （40 cases） was salpingian neoplasty under abdominoscope. The incidences of uterine pregnancy and once again tubal pregnancy and secondary sterility were compared. All cases were followed up 2 - 4 years. Results： The incidence of pregnancy in group B and group C was higher and the incidence of once again heterotopic pregnancy was not increased. The indexes among four groups had not remarkable difference after one year. Conclusion： The conservative treatment on the tubal pregnancy is better way for the women who wish to pregnancy again.