保守疗法治疗输卵管妊娠后再次妊娠结局分析

摘要

Objective To explore the different conservative manners or methods of treatment for unruptured tubal pregnancy 2 years after pregnancy,seeking better treatment for tubal pregnancy and on subsequent pregnancy affected treatment method.Methods We summarized and analyzed the clinical data of 123 cases of unruptured ectopic pregnancy patients treated by different methods from January 2005 to December 2009 in our hospital.According to different methods of conservative treatment they were divided into laparoscopic group (group A),using Laparoscopic salpingostomy in 69 cases.Drug group (group B) with 54 cases was given mifepristone or mifepristone combined with methotrexate.Comparison of two groups were followed up for 2 years after menstrual recovery,Re-pregnancy,intrauterine pregnancy,ectopic pregnancy and infertility again occurrence.Results Within 2 years the intrauterine pregnancy rate was 50.72％ (35/69) in group A,higher than that in the group B [35.19％(19/54)].Average pregnancy time in group A was (10.53 ± 2.05) months,shorter than that of the group B [(14.12 ± 3.15) months].Secondary infertility in group A was 27.54％(19/69),lower than that of the group B,38.89％(21/54).Repeated ectopic pregnancy in group A was 21.74％ (15/69),while the group B was 25.92％ (14/54).The pregnancy time,intrauterine pregnancy and secondary infertility in comparison in two groups,the difference was statistically significant (P＜0.05),the difference between the repeated ectopic pregnancy in two groups was not statistically significant (P＞0.05).Conclusions The operation of laparoscopic conservative treatment for tubal pregnancy patients is better than conservative treatment.%目的 探讨不同的保守方式或方法治疗未破裂型输卵管妊娠后的2年内再次妊娠的情况,寻求对输卵管妊娠较好的治疗方法及对再次妊娠影响较小治疗方法.方法 总结分析2005年1月至2009年12月于广东省高要市人民医院采用不同治疗方法治疗的123例未破裂型异位妊娠患者的临床资料,根据不同的保守治疗方法分为腹腔镜组(A组),行腹腔镜下输卵管造口术69例;药物组(B组)予米非司酮或米非司酮加甲氨蝶呤治疗54例.比较两组术后随访2年术后月经恢复情况,再次妊娠时间、宫内妊娠、再次异位妊娠及继发不孕的发生情况.结果 2年内宫内妊娠率A组为50.72％(35/69)高于B组35.19％ (19/54)、平均再次妊娠时间A组(10.53±2.05)月小于B组(14.12±3.15)月,继发性不孕A组27.54％(19/69)小于B组38.89％(21/54),再次异位妊娠A组21.74％(15/69),B组25.92％(14/54).两组在再次妊娠时间、宫内妊娠及继发不孕方面比较,差异有统计学意义(P＜0.05),再次异位妊娠两组间差异无统计学意义(P＞0.05).结论 腹腔镜手术保守治疗输卵管妊娠患者优于药物保守治疗.