重复异位妊娠的高危因素分析

Analysis of the causation factors of recurrent ectopic pregnancies

目的:探讨重复异位妊娠发生的高危因素。方法:1 560例异位妊娠保守治疗患者,成功随访有生育要求的360例患者,追踪生育结局。结果:重复异位妊娠的发生率为25.8%,其中前次异位妊娠治疗方法为经腹腔镜手术发生率为18.3%,经开腹手术为45.1%,药物保守治疗为31.7%,差异有统计学意义(P<0.01)。72例术中发现盆腔粘连,重复异位妊娠54.8%发生在同侧输卵管,45.2%发生在对侧输卵管。结论:重复异位妊娠的发生主要与盆腔炎症及前次异位妊娠的治疗方法有关。加强健康教育,积极防治盆腔炎性疾病,选择腹腔镜手术是预防重复异位妊娠发生的重要手段。

Objective：To investigate the the causation factors of recurrent ectopic pregnancies. Methods：The data of 1 560 cases with ectopic pregnancy treated with conservative method were retrospectively analyzed. The birth outcomes of 360 cases with fertility requirements were successfully tracked. Results： The incidence of recurrent ectopic pregnancies was 25. 8% , the incidence of laparoscopic surgery, laparotomy surgery and conservative treatment with drugs were 18.3% ,45.1% and 31.7% rspeetively, and the differences had statistical significance（ P 〈 0.01 ）. Pelvic adhesion in 72 cases, ipsilateral tubal pregnancy（ 54.8% ） and contralateral tubal pregnancy（45.2% ） were found. Conclusions：The recurrent ectopic pregnancies were related to pelvic inflammatory and previous treatment methods. Strengthening health education, preventing and treating pelvic inflammatory and selecting laparoscopic surgery can prevent the recurrent ectopic pregnancies.