32例重复异位妊娠患者的临床分析

目的：分析重复异位妊娠（repeat ectopic pregnancy,REP）的诊断、治疗和结局,为有效降低REP发生率,提高宫内妊娠率提供依据.方法：回顾分析2002年1月-2011年10月我院收治的REP患者32例,分析前次妊娠盆腔粘连、治疗方式与本次妊娠之间的关系.结果：32例REP患者中有人工流产或药物终止妊娠病史患者27例,有盆腔炎史患者14例,有盆腹腔手术史患者15例.首次异位妊娠经保守性手术治疗和药物保守治疗后,再次异位妊娠多发生于原患侧;首次患侧输卵管切除后再次异位妊娠多发生于对侧（P＜0.01）.结论：慢性输卵管炎是REP的主要原因,应彻底治疗生殖道炎性反应及首次异位妊娠,并减少宫腔操作及盆腹腔手术率.

Clinical Analysis of 32 cases of Repeated Ectopic Pregnancy

Objective：To investigate the diagnosis,treatment and outcome of patients with repeat ectopic pregnancy （REP）,in order to provide a basis for decreasing the incidence of REP and increasing the intrauterine pregnancy rate.Methods：Thirty-two cases of REP were selected from January 2002 to October 2011.The relationship among previous pregnancy pelvic adhesions,treatment methods and the current pregnancy was analysed.Results：Among 32 cases of REP,27 cases had abortion,14 cases had pelvic inflammatory diseases,and 15 cases had intra-abdominal surgery.REP occurred more in original side after treatment of first ectopic pregnancy with conservative surgery and medicine.REP occurred more in contralateral side after first-time ipsilateral salpingectomy（P＜0.01）.Conclusions：Chronic salpingitis is the main reason for REP.Thorough treatment of genital tract inflammation and first-time ectopic pregnancy may reduce the incidence of REP.