输卵管妊娠保守手术后持续性异位妊娠研究.docVIP

输卵管妊娠保守手术后持续性异位妊娠研究 　　[摘要] 目的 探讨持续性异位妊娠（PEP）发生的临床危险因素。方法 796例行腹腔镜保守性手术的输卵管妊娠患者中，PEP患者24例列入研究组，其余患者772例列入对照组，回顾性比较和分析所有患者临床基本资料和手术资料。结果 研究组患者停经时间在40d以内的比例5.42%明显高于41d以上1.98%（χ2＝6.27，P＜0.05）；研究组采用胚胎挤出/吸除术治疗患者比例18%明显高于输卵管切开取出胚胎手术2.01%（χ2＝21.32，P＜0.01），术中使用MTX患者比例0.95%明显低于未使用患者7.04%（χ2＝8.29，P＜0.05）。结论 停经时间短、采用胚胎挤出/吸除术式和术中不应用MTX的患者PEP发病率较高。 　　[关键词] 输卵管妊娠；腹腔镜；保守治疗；持续性异位妊娠 　　[中图分类号] R714.22[文献标识码] B[文章编号] 1673-9701（2011）27-141-02 　　 　　Study of Persistent Ectopic Pregnancy after Laparoscopic Conservative Surgery in Patients with Tubal Pregnancy 　　FENG Shuqun 　　The Fourth Ward of Women and Children’s Hospital in Ningbo City, Ningbo 315010, China 　　 　　[Abstract] Objective To discuss the clinical risk factors of persistent ectopic pregnancy（PEP）. Methods In 796 tubal pregnancy patients treated by laparoscopic conservative surgery, 24 cases who had PEP were distributed into study group and other 772 cases were distributed into control group. The clinical basic information and surgical data of all the patients were retrospectively compared and analyzed. Results The PEP incidence with menopause time less than 40 days 5.42% was significantly higher than that more than 41 days 1.98% (χ2=6.27, P＜0.05). The treatment rate with embryo extrusion/suction technique 18% was significantly higher than that with tubal incision technique 2.01% in PEP（χ2=21.32, P＜0.01）. Treatment rate with MTX 0.95% was significantly lower than without MTX 7.04% in PEP（χ2=8.29, P＜0.05）. Conclusion Patients of short menopause time, treated by embryo extrusion/suction technique, and treated without MTX had a higher PEP incidence. 　　[Key words] Tubal pregnancy; Laparoscopic; Conservative surgery; Persistent ectopic pregnancy 　　 　　随着医疗领域对微创技术的不断探索与应用，目前在异位妊娠的临床治疗方法上，已经逐渐由腹腔镜手术替代传统的开腹手术[1]。作为一种有效的保守治疗手段，腹腔镜手术具有创伤小、出血少、康复快、并发症少等优点。但随着临床对其应用的逐渐增多，持续性异位妊娠（persistent ectopic pregnancy，PEP）的病例也不断出现并受到关注[2]。本文笔者回顾性分析我院2005年1月～2010年12月经保守性手术治疗的患者796例，探讨PEP发生的危险因素，现报道如下。 　　1资料与方法 　　1.1一般资料 　　796例患者均因输卵管妊娠而行