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目的分析腹腔镜下输卵管妊娠保守性手术后持续性异位妊娠(persistent ectopie pregrmncy,PEP)的因素。方法对2010年1月~2013年5月145例输卵管妊娠腹腔镜下保守性手术患者进行回顾性分析。结果 145例输卵管妊娠腹腔镜下保守性手术患者中发生PEP者19例,发生率为13.1%。PEP组有异位妊娠史者明显高于非PEP组(P<0.05),住院时间长于非PEP组(P<0.05),术前β-HCG水平明显高于非PEP组,黄体切除率明显低于非PEP组,盆腔粘连发生率明显高于非PEP组(P<0.05),而两组年龄、停经时间和包块直径方面比较差异无统计学意义(P>0.05)。结论输卵管妊娠腹腔镜保守性手术后PEP的发生与患者的异位妊娠史、术前血β-HCG水平、黄体切除和盆腔粘连密切相关,术后监测血β-HCG水平的变化有利于早期发现和预防PEP的发生。
Objective To analyze the factors of persistent ectopie pregrmncy (PEP) after laparoscopic conservative surgery for tubal pregnancy. Methods From January 2010 to May 2013, 145 cases of tubal pregnancy under laparoscopic conservative surgery were retrospectively analyzed. Results Of the 145 cases of tubal pregnancy, laparoscopic conservative surgery in patients with PEP in 19 cases, the incidence was 13.1%. The history of ectopic pregnancy in PEP group was significantly higher than that in non-PEP group (P <0.05), and the length of hospital stay was longer than that in non-PEP group (P <0.05). The preoperative β-HCG level was significantly higher than that of non-PEP group and the corpus luteum resection rate was significantly lower In non-PEP group, the incidence of pelvic adhesions was significantly higher than that of non-PEP group (P <0.05), but there was no significant difference between the two groups in age, menopause time and mass diameter (P> 0.05). Conclusions The occurrence of PEP after laparoscopic conservative surgery for tubal pregnancy is closely related to the history of ectopic pregnancy, preoperative serum levels of β-HCG, luteal removal and pelvic adhesions. The change of postoperative β-HCG levels in blood is in favor of early detection And prevent the occurrence of PEP.