输卵管妊娠患者治疗后再次妊娠情况分析

Analysis of re-pregnancy after treatment of tubal pregnancy patients

(1)目的探讨输卵管妊娠后患者再妊娠的情况。(2)方法对我院2014年1月~2017年12月诊断并完成治疗的输卵管妊娠患者进行电话随访,选取随访成功并有生育要求的患者179例,根据治疗方式,分为药物治疗组62例,手术治疗组117例;手术治疗组中包括保留输卵管患者65例,切除患侧输卵管患者52例。比较不同治疗方式对患者再妊娠的影响,同时分析不同治疗方式对患者再妊娠所需时间的影响。(3)结果药物治疗组患者再次正常宫内受孕的发生率(46.8%)高于手术治疗(30.8%),差异有统计学意义(P<0.05),再次异位妊娠的发生率(9.7%)低于手术治疗组(15.4%),但差异无统计学意义(P>0.05)。药物治疗组与手术治疗组患者中位自然妊娠时间分别为25月、36月,差异有显著性统计学意义(χ~2=21.693,P=0.000)。保留输卵管手术治疗的患者再次发生异位妊娠(21.5%)高于切除患侧输卵管手术治疗的患者(7.7%),差异有统计学意义(P<0.05);再次正常宫内受孕的发生率(36.9%)也高于切除患侧输卵管手术治疗的患者(23.1%),但差异无统计学意义(P>0.05)。(4)结论输卵管妊娠患者经药物治疗后自然妊娠的几率高于手术治疗,所需的时间比手术治疗的患者更短。保留输卵管手术治疗后发生再次异位妊娠几率高于切除患侧输卵管手术患者。

Objective To explore the fertility status of those who once experienced tubal pregnancy.Methods 179 patients who experienced tubal pregnancy during January 2014 and December 2017 was collected.All of them had fertility requirements and were followed.According to the treatment method,62 cases were belong to medicine group and 117 cases belongs to surgery group.Among surgery group, there were 65 patients with affected tube reserved and 52 cases with the tube removed. The effects of different treatments for fertility status was recorded.Results(1)The incidence of normal pregnancy in medicine group was 46.8%, which was much higher than that in surgery group(30.8%)(P<0.05).while the incidence of re-ectopic pregnancy(9.7%) was lower than that in surgery group(15.4%)(P>0.05).(2)The median natural pregnancy time of the medicine group and the surgery group was 25 months and 36 months respectively,and the difference was statistically significant(χ~2=21.693,P=0.000).(3)The incidence rate of re-ectopic pregnancy was 21.5% in those who had tube reserved, which was higher than those who had tube removed(7.7%)(P<0.05), the incidence of normal pregnancy(36.9%) was also higher than that in tube removed(23.1%)(P>0.05).Conclusion For those experienced tubal pregnancy there is more chance and less time to have normal pregnancy in those had medicine than those had surgery. Those who had tube reserved had more chance to have re-ectopic pregnancy than those had tube removed.