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目的分析重复异位妊娠的主要高危因素,探讨防治的有效措施。方法通过分析漳州市医院收治的83例重复异位妊娠的临床特点、生育情况、首次治疗方法及术中所见,探讨病因及防治措施。结果 83例重复异位妊娠患者中,2次异位妊娠占92.8%,有剖宫产史占已生育患者的84.0%(21/25),有流产史73.5%,盆腔炎病史65.1%。药物保守治疗5例(6.0%),行腹腔镜术78例(94.0%),其中70例(89.7%)术中发现不同程度的盆腹腔粘连。切除患侧输卵管组再发同侧异位妊娠比例(14.0%)低于保守治疗(55.0%)和保守性手术组(53.6%)。结论减少流产及剖宫产、积极防治盆腔炎可降低异位妊娠的发生。首次异位妊娠及时合理治疗,是降低重复异位妊娠发生的有效措施,患侧输卵管切除可减少再次异位妊娠。
Objective To analyze the main risk factors of repeated ectopic pregnancy and to explore effective measures for prevention and treatment. Methods 83 cases of repeated ectopic pregnancy hospitalized in Zhangzhou City Hospital were analyzed clinical features, fertility, the first treatment and intraoperative findings, to explore the etiology and prevention and treatment measures. Results Among the 83 patients with repeated ectopic pregnancy, 2 ectopic pregnancies accounted for 92.8%, cesarean section accounted for 84.0% (21/25), 73.5% had abortion, and 65.1% had pelvic inflammatory disease. Five cases (6.0%) were treated conservatively and 78 cases (94.0%) were performed laparoscopy. Among them, 70 cases (89.7%) found intraperitoneal adhesions to varying degrees. The proportion of resected ipsilateral tubal group with ipsilateral ectopic pregnancy (14.0%) was lower than conservative treatment (55.0%) and conservative surgery group (53.6%). Conclusions Reduction of abortion and cesarean section, prevention and treatment of pelvic inflammatory disease can reduce the incidence of ectopic pregnancy. The first ectopic pregnancy timely and reasonable treatment is to reduce the occurrence of repeated ectopic pregnancy effective measures, ipsilateral tubal resection can reduce the recurrence of ectopic pregnancy.