重复异位妊娠91例临床分析.DOCVIP

临床医学论文-重复异位妊娠91例临床分析 【关键词】? 重复异位妊娠 ??? 摘? 要：目的：了解重复异位妊娠病因，发病特点及结局，提高对本病的认识，减少误诊，寻求及时适当的治疗方案，减轻对患者损伤。方法：对1999年1月至2004年1月我院收治的1380例异位妊娠病例进行回顾性分析。结果：1380例异位妊娠发生重复异位妊娠91例（占6.59%），84例经手术探查证实为输卵管妊娠， 6例为输卵管妊娠3次，7例为药物保守治疗治愈，86.81%重复异位妊娠为连续两次异位妊娠。90.41%输卵管切除者的重复异位妊娠发生在对侧，而保守治疗者72.22%发生在原患侧，两者有显著性差异（P0.001）。结论：本病的发病与输卵管炎症及前次异位妊娠有关。治疗应根据患者的生育要求，患侧及对侧输卵管情况及内出血情况等决定。可采取选择期待治疗；药物保守治疗；输卵管切除或保留输卵管手术。 　　关键词：? 重复异位妊娠；? 输卵管；? 药物保守治疗 　　Analysis of 91 Cases of Repeat Ectopic Pregnancy 　　Abstract: Objective: To realize 91 cases of repeat ectopic pregnancy depending on the pathogeny, clinical findings and leading to the rational treatment.Method: From Jan. 1999 to Jan. 2004, ninety-one cases of repeat ectopic pregnancy were demonstrated from 1380 cases of ectopic pregnancy.Result: The repeat ectopic pregnancy was 6.59% (91/1380) after operation, eighty-four cases demonstrated as tubal pregnancy, six cases were tubal pregnancy three times, seven cases were cured by conservative medication，the recurrence of repeat ectopic pregnancy of twice was 86.81% (79/91). After salpingectomy of the patients who occurred the another tubal pregnancy was 90.41%. In the same side of former tubal pregnancy by conservative medication was 77.22%.Conclusion: The causes of repeat ectopic pregnancy resulted from salpingitis or persistency ectopic pregnancy. The treatment is depending on the procreative requirement of the patient, condition of both fallopian tubes and internal bleeding. In conventional therapy enclosed conservative medication, salpingectomy or saved fallopian tube operation. 　　Key words:? Repeat ectopic pregnancy；? Fallopian tube；? Conservative medication 　　重复性异位妊娠是指首次异位妊娠经手术或保守性治疗（手术或药物）等，再次在子宫外、输卵管、卵巢或腹腔内妊娠者［1］。近年来随着异位妊娠发病率例逐年增高，重复异位妊娠的发病率也有所上升，其危害性大。本文通过重复性异位妊娠1380进行回顾性分析，对其发生，诊断，治疗及预防等方面进行初步探讨。 　　1? 临床资料 　　1.1? 一般资料：我院从1999年1月至2004年1月共收治异位妊娠1380例，其中91人为重复异位妊娠，发生率6.59%，其中6例为连续3次异位妊娠，患者发病年龄20～34岁，人流史75例，人流次数1～4次不等，无人流史9例，7例有产褥期感染史。 　　1.2? 诊断标准：将首次异位妊娠经手术或保守性治疗后，再次在子宫外的输卵管、卵巢或腹腔内妊娠者诊断为重复异位妊娠。