两种输卵管妊娠保守治疗方法对再次妊娠结局的影响

The influence of two conservative therapy for tubal pregnancy on the outcome of future pregnancy

目的:对比分析腹腔镜保守手术及药物保守治疗输卵管妊娠的效果,探讨两种治疗方法对再次妊娠的影响。方法:回顾分析输卵管妊娠患者112例的临床资料,根据治疗方法分为腹腔镜保守治疗组(60例)和药物保守治疗组(56例)。术后随访48个月,观察再次妊娠的结局。结果:腹腔镜保守治疗组术后宫内妊娠率明显高于药物治疗组,差异有统计学意义(P<0.05);术后重复异位妊娠率及继发不孕率两组差异无统计学意义(P>0.05)。结论:腹腔镜保守手术可提高宫内妊娠率,并不增加术后重复异位妊娠及继发不孕的风险,作为有生育要求的输卵管妊娠患者是较理想的治疗方法。

Objective：To evaluate the influence on the pregnancy outcome after laparoscopic salpingotomy and conservative medicine therapy for tubal pregnancy.Methods：The clinical data of 112 patients of tubal pregnancy was retrospectively analyzed,and the patients were divided into two groups according to the treatment：laparoscopic salpingotomy（group Ⅰ,n= 60） and conservative medicine therapy（group Ⅱ,n= 56）.The follow-up was 48 months.The outcome of future pregnancy was compared.Results：The percentages of intrauterine pregnancy was significantly higher in group I than in group Ⅱ（P 0.05）;there was no significant difference between the two groups in the repeated ectopic pregnancy（REP） and secondary infertility（P0.05）.Conclusions：Laparoscopic salpingotomy has beneifit to incresae the percentages of intrauterine pregnancy over the conservative medicine therapy for tubal pregnancy,and does not increase the risks of REP and secondary infertility.Laparoscopic salpingotomy is recommended as a ideal method in the management of patients with tubal pregnancy who desire future pregnancy.