腹腔镜下输卵管切除术后持续性异位妊娠11例临床分析

Clinical analysis of 11 cases of persistent ectopic pregnancy after laparoscopic salpingectomy

目的探讨腹腔镜下输卵管切除术后持续性异位妊娠(persistent ectopic pregnancy,PEP)的临床特征及防治措施。方法回顾性分析浙江大学医学院附属妇产科医院2009年1月至2011年12月因输卵管妊娠行腹腔镜下输卵管切除术患者1930例的临床资料,其中术后发生PEP 11例,占0.57%。结果发生PEP患者术中发现输卵管妊娠流产型和既往有输卵管手术史的概率以及术前血清β-绒毛膜促性腺激素(β-hCG)水平均显著高于未发生PEP患者(P<0.05)。结论输卵管妊娠流产型特别是伴血清β-hCG高的患者,输卵管切除术后应该随访检测血清β-hCG。

Objective To investigate the clinical features of persistent ectopic pregnancy （PEP） after laparoscopic salpin- gectomy, and its prevention measures. Methods A retrospective analysis was conducted on 1930 patients treated by lap- aroscopic salpingectomy because of tubal ectopic pregnancy between Jan. 2009 and Dec. 2011 at Women＇s Hospital, Zhe- jiang University School of Medicine. Among them, 11 patients had PEP, accounting for O. 57% （11/1930）. Results The levels of serum β- human chorionic gonadotropin （β-hCG） before operation, and the incidence of tubal abortion and previous tubal surgery were all significantly higher in patients with PEP than those in patients without PEP （P 〈 0.05）. Conclusion Following salpingectomy women with a tubal miscarriage are advised to have serum β-hCG levels moni- tored.