重复异位妊娠80例临床分析

Clinical analysis of 80 cases of repeated ectopic pregnancy

目的探讨重复异位妊娠的相关因素及防治。方法通过对近3年所有异位妊娠及重复异位妊娠的相关因素进行回顾性分析。结果重复异位妊娠80例,占同期937例异位妊娠中的8.5%,94%输卵管切除者的重复异位妊娠发生在对侧;异位妊娠行保守性治疗者(包括保守性手术及药物保守治疗)83.9%的再次异位妊娠发生在原患侧。80例重复异位妊娠患者中,有67例曾行手术治疗,术中发现盆腔粘连38例,输卵管积水2例,合并子宫肌瘤2例,输卵管过长3例,正常盆腔37例。在67例手术患者中证实异位妊娠合并盆腔炎及输卵管炎症者有40例,占59.6%。结论无论是保守治疗(药物保守治疗及手术保守治疗)还是根治性手术治疗(输卵管切除)后重复妊娠率增高。输卵管因素及盆腔炎症是重复异位妊娠的最重要危险因素。本病的发生与盆腔炎症及前次异位妊娠治疗方式有关。应积极治疗盆腔炎症,从首次异位妊娠的防治开始来降低重复异位妊娠的发生率。

【Objective】To explore the related factors of repeated ectopic pregnancy and prevention. 【Methods】By retrospective analysis of nearly 3 yearsall ectopic pregnancy and ectopic pregnancy relanted factors. 【Results】80 cases of repeated ectopic pregnancy, which accounted for 8.5% of ectopic pregancyin 937 cases, occurred in the contralateral recurrent ectopic 94% tubal excisionof the pregnancy; conservative treatment of ecopic pregnangcy（including conservative conservative operation and drug） occurred in the ispsilaeral 83.9% again ectopic pregnancy. 80 cases of patients with ectopic pregnancy, 67 cases underwent operation treatment, pelvic adhesion was found in 38 cases, 2 cases of hydrosalpinx, 2 cases with myoma of uterus, 3 cases of fallopian tube is too long, the normal pelvic cavity in 37 cases. In 67 cases confirmed by operation in patients with pelvic inflammatory disease and fallopian tube inflammation is associated with ectopic pregnangcy in 40 cases, accounting for 59.6%.【Conclusion】Both conservative therapy（conservative treatment and conservative） treatment or operation） radical operation therapy（salpingectomy） after repeated pregnancy rate.Tubal factor and pelvic inflanmmation is one of the mostimportant risk factor for repeat ectopic pregnancy. Occurrence and pelvic inflammory disease and previous ectopic pregnancy reatment of this disease.should the active treatment of pelvic inflammatory disease, prevention and treatment of ectopic pregnancy from the first beginning to reduce the incidenceof ectopic pregnancy.