重复异位妊娠78例临床分析

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目的:探讨重复异位妊娠的病因及防治措施。方法:回顾性分析柳州市妇幼保健院2006年~2007年收治的78例重复异位妊娠患者的临床资料。结果:78例重复异位妊娠患者中,28例有盆腔炎史,45例有流产史,67例有盆、腹腔手术史。78例患者均行腹腔镜检查及手术治疗,术中发现均为输卵管妊娠,其中61例有不同程度的盆腔粘连;首次异位妊娠行保守性手术或药物治疗者,再次异位妊娠多发生在同侧;23例行患侧输卵管切除,55例行输卵管妊娠病灶清除,所有病例均成功治愈;21例病理证实有慢性输卵管炎。结论:慢性输卵管炎、盆腔粘连是重复异位妊娠的根本原因。彻底治疗生殖道炎症及首次异位妊娠,减少流产及盆、腹腔手术史是降低重复异位妊娠的发生率的关键。腹腔镜治疗重复异位妊娠安全有效。 Objective: To investigate the etiology and prevention and treatment of repeated ectopic pregnancy. Methods: The clinical data of 78 patients with repeated ectopic pregnancy admitted to Liuzhou Maternal and Child Health Hospital from 2006 to 2007 were analyzed retrospectively. Results: Of 78 patients with recurrent ectopic pregnancy, 28 had history of pelvic inflammatory disease, 45 had abortion history, and 67 had history of pelvic and abdominal surgery. 78 patients underwent laparoscopy and surgical treatment, intraoperative findings were tubal pregnancy, of which 61 cases of varying degrees of pelvic adhesions; first ectopic pregnancy underwent conservative surgery or drug treatment, and more ectopic pregnancy occurred in Ipsilateral; 23 cases of ipsilateral tubal resection, 55 cases of tubal pregnancy lesions cleared, all cases were successfully cured; 21 cases of pathological confirmed chronic salpingitis. Conclusion: Chronic salpingitis and pelvic adhesions are the root causes of repeated ectopic pregnancy. Complete treatment of reproductive tract inflammation and ectopic pregnancy for the first time, to reduce abortion and pelvic and abdominal surgery history is to reduce the incidence of repeated ectopic pregnancy key. Laparoscopic treatment of repeated ectopic pregnancy safe and effective.
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