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目的:探讨首次异位妊娠不同处理方式与重复异位妊娠的发病因素及结局。方法:回顾性调查,2005年1月~2013年12月,我院326例异位妊娠,其中筛除双侧输卵管切除或绝育术者20例,年龄巳达绝经期者2例,对294例重复异位妊娠、异位妊娠发生的情况,以及首次异位妊娠的治疗方法进行分析,重复异位妊娠中前末次妊娠的情况,重复异位妊娠与首次异位妊娠所见输卵管炎症情况之间的关系。结果:294例弄位妊娠中发生重复异位妊娠27例,发生率9%,手术治疗(开腹清除病例输卵管,不包括切除或结扎对侧输卵量)96例,发生重复异位妊娠17例,发生率15.9%。药物保守治疗(指M·T·X分次肌注加中药口服外敷治疗)组192例,发生重复宫外孕12例,发生率5.2%,两者间差异有显著性(P<0.05)。输卵管有肉眼炎症表现者85%病例重复异位妊娠发生在炎症侧,而重复异位妊娠发生在无肉眼炎症侧者仅为34%(P<0.01)。结论:输卵管炎症与手术治疗异位妊娠是重复异位妊娠的危险因素,药物保守治疗发生重复异位妊娠率要比手术治疗发生重复异位妊娠率要低。
Objective: To explore the etiological factors and outcomes of different etiological treatments and repeated ectopic pregnancy. Methods: Retrospective investigation, from January 2005 to December 2013, 326 cases of ectopic pregnancy in our hospital, including 20 cases of bilateral tubal resection or sterilization, 20 cases of age had reached menopause, 294 cases Repeat ectopic pregnancy, ectopic pregnancy occurred, and the first ectopic pregnancy treatment analysis, repeat the last pregnancy in ectopic pregnancy, repeated ectopic pregnancy and tubal inflammation seen in the first ectopic pregnancy between Relationship. Results: Totally 294 cases of repeat ectopic pregnancy in pregnancy occurred in 27 cases, the incidence of 9%, surgical treatment (open case of tubal excision, excision or ligation of contralateral ovulation) 96 cases of repeated ectopic pregnancy 17 For example, the rate of 15.9%. 192 cases of conservative treatment of drug (referring to M · T · X fractionated intramuscular injection plus oral administration of traditional Chinese medicine) group were repeated ectopic pregnancy in 12 cases (5.2%), the difference was significant (P <0.05). Tubal inflammation with naked eye showed that 85% cases of repeat ectopic pregnancy occurred in the inflammation side, and repeated ectopic pregnancy occurred in no side of the eye inflammation was only 34% (P <0.01). Conclusion: Tubal inflammation and surgical treatment of ectopic pregnancy are risk factors for repeated ectopic pregnancy. Repeated ectopic pregnancy with conservative treatment is less frequent than surgical treatment with repeated ectopic pregnancy.