重复异位妊娠29例临床分析

目的：探讨重复异位妊娠发生的相关因素及其预防措施。方法：回顾性分析我院1995年12月～2003年12月收治的29例重复异位妊娠妇女的临床资料及治疗情况。结果：29例重复异位妊娠占同期452例异位妊娠中的6．42％，其中19例(占65．52％)发生在对侧输卵管，10例(占34．48％)发生在同侧输卵管。首次异位妊娠行一侧输卵管切除术20例，重复异位妊娠发生在对侧18例(占90．00％)，发生在同侧2例(占10．00％)。首次异位妊娠行保守性手术及药物治疗9例，重复异位妊娠发生在同侧8例(占88．89％)，发生在对侧1例(占11．11％)。本组病例15例手术后病理示合并慢性输卵管炎，占51．72％。首次异位妊娠后未避孕及无规律避孕21例，占72．41％。结论：输卵管炎、首次异位妊娠的治疗方式及无避孕措施或不严格避孕是重复异位妊娠的危险因素。应积极治疗输卵管炎症，从首次异位妊娠的防治开始来降低重复异位妊娠的发病率。

Clinical analysis of 29 Patients with Repeated Ectopic Pregnancy

Objective: To explore the risk factors and preventive measures of repeated ectopic pregnancy. Methods: The clinical data of 29 cases with repeated ectopic pregnancy in our hospital during Dec. 1995 to Dec. 2003 were retrospectively analysed. Results: There were 29 cases of repeated ectopic pregnancy among 452 patients during the same period, the incidence was 6. 42%. Among them, 19(65. 52%)cases occurred on contralateral fallopian tube;10 cases (34. 48%) occurred on the same side. There were 20 cases of first radical resection of the affected fallopian tube,18 cases(90. 00%) of repeated ectopic pregnancy occurred on contralateral fallopian tube,2 cases(10. 00%) occurred on the same side. There were 9 cases with conservative surgery and medical conservative treatment, 8 cases(88. 89%)of repeated ectopic pregnancy occurred on the same side,1 casedl. 11%) occurred on contralateral fallopian tube. After operation, chronic salpingitis was found in 15 cases(51. 72%). There were 21 cases (72. 41 %)without contraception and occasional contraception after the first ectopic pregnancy. Conclusion:The risk factors of repeated ectopic pregnancy include salpingitis; the treatment of the first ectopic pregnancy, no contraception and contraception occasionally. Effective treatment of the salpingitis and avoiding the first ectopic pregnancy are the important measures for prevention of repeated ectopic pregnancy.