重复异位妊娠的危险因素与防范对策的探讨

目的探讨重复异位妊娠发生的危险因素及防范对策。方法回顾性分析在491例异位妊娠中30例重复异位妊娠患者的资料。结果重复异位妊娠的发病率为6．1％。平均年龄29．5岁。有流产史21例，有慢性盆腔炎史12例，不孕史9例。首次异位妊娠行患侧输卵管切除13例，重复异位妊娠部位发生在对侧者7例，同侧仅6例。首次异位妊娠保守性手术治疗17例，重复异位妊娠发生在对侧7例，同侧10例。术中发现有盆腔粘连19例。结论反复流产、不孕史是异位妊娠的不良病史，无有效避孕措施、盆腔粘连、输卵管炎症表现和保守性手术治疗是重复异位妊娠发生的危险因素。治疗方法为加强健康教育，积极治疗不孕症和盆腔炎性疾病，选择正确的手术方式。

Study on risk factors Of repeated ectopic pregnancy and preventive measures

Objective To investigate the risk factors of recurrent ectopic pregnancy（REP） and preventive measures. Methods A retrospective study was performed. This study was carried out in 30 cases of REP out of 491 cases of ectopic pregnancy. Results The incidence rate of REP was 6. 1% （30/490）. The average age was 29.5 years old. 21 cases had miscarriage history, 12 cases had chronic pelvic inflammatory disease history, and 9 cases had infertility history. 13 cases of ectopic pregnancy in the first time were operated with salpingectomy, but the REP happened to the con tralateral oviduct in 7 cases and the homolateral oviduct in 6 cases. 17 cases of ectopic pregnancy in the first time were conservative treatment, but the REP happened to the con-tralateral oviduct in 7 cases and the homolateral oviduct in 10 cases. Operation revealed pelvic adhension in 19 cases. Conclusion Repeated .miscarriage and infertility history are the unhealthy medical record. Ineffective contraception methods, pelvic adhension, inflamed salpinx and conservative treatment are risk factors of REP. To enhance health education,effective treatment of infertilitas feminis and pelvic inflammation and selecting correct treatment modus operandi of the first heterotopic pregnancy are the important measures for prevention of REP.