输卵管妊娠保守治疗后生育结局分析

Analysis of reproductive outcomes after different conservative treatments for tubal pregnancy

目的观察不同保守性方法治疗输卵管妊娠后患者生育结局。方法回顾性分析223例输卵管妊娠住院治疗资料,按药物保守治疗(55例)、腹腔镜保守治疗(118例)及血管介入治疗(50例)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。结果腔镜组及介入组的3个月输卵管通畅率明显高于药物组(90.68%和90.00%vs.56.36%)(P<0.01);腔镜组和介入组2年不孕率明显低于药物组(20.34%和20.00%vs.38.18%)(P<0.05)。结论对宫外孕患者宜依据不同病情选择治疗方法。与药物治疗比较,腔镜及介入治疗后3个月输卵管通畅率较高,而2年不孕率较低。

Objective To compare the reproductive outcomes after three conservative treatments for tubal pregnancy. Methods A total of 223 patients with tubal pregnancy was divided to three groups of A（55 cases,treated with drugs）,B（118 cases,treated with laparoscopic conservative surgery） and C（50 cases,treated with radiation treatment of vascular interventional means）.The reproductive outcomes were compared. Results Tubal patency rate after three months was higher in groups of B and C than that in group A（90.68% and 90.00% vs.56.36%）（P0.01）.The 2-year infertility rate was lower in groups of B and C than that in group A（20.34% and 20.00% vs.38.18%）（P0.05）.Conclusion The treatment should be selected on the basis of dofferent conditions of tubal pregnancy.Compared to drugs therapy,laparoscopic conservative surgery and radiation treatment have higher tubal patency rate and lower 2-year infertility rate.