重复异位妊娠32例临床分析

目的探讨重复异位妊娠的临床特征、诊断、治疗及预防。方法回顾性分析2005年10月～2010年10月在我院住院治疗的32例重复异位妊娠的临床资料。结果异位妊娠32例,占同期异位妊娠7.17%,平均发病年龄（34±0.8）岁,两次异位妊娠平均间隔时间38.72个月,多有停经、腹痛、阴道流血、妇检阳性、hCG增高及B超示附件包块等表现,4例药物保守治疗成功,28例手术治疗,其中保守手术11例,患侧输卵管切除17例,加对侧输卵管结扎5例,术中证实均系输卵管妊娠,有盆腔粘连21例（75%）。结论重复异位妊娠好发于年轻女性,盆腔炎症、首次异位妊娠保守治疗是其发病的高危因素,减少盆腔炎性疾病的发生、首次异位妊娠合理、及时的治疗以及术后有效监测和治疗是预防重复异位妊娠的有效方法。

Recurrent ectopic pregnancy 32 cases clinical analysis

Objective To investigate the clinical features,diagnosis,treatment and prevention of recurrent ectopic pregnancy.Methods Clinical data of 32 cases of recurrent ectopic pregnancy were reviewed from October 2005 to October 2010 in our hospital.Results Of 32 ectopic pregnancy cases,ectopic pregnancy accounted for 7.17% over the same period,the mean age of（34±0.8）years old,the average interval between ectopic pregnancy 38.72 months,clinical symptoms including menopause,abdominal pain,vaginal bleeding,positive gynecological examining,higher HCG and B ultrasound showing adnexal mass and so on.Of 32 cases,4 patients with drug-conservative treatment,28 cases of surgical treatment,conservative surgery in 11 cases,17 cases of ipsilateral salpingectomy,plus 5 cases of contralateral tubal ligation,surgery confirmed they were all tubal pregnancy,pelvic adhesions in 21 cases（75%）.Conclusion Recurrent ectopic pregnancy usually occurs in young women,The risk factors are pelvic inflammatory disease,the first ectopic pregnancy and conservative treatment.Reduce the incidence of pelvic inflammatory disease,a reasonable and timely treatment of the first ectopic pregnancy and postoperative effective monitoring and treatment is an effective prevention method of recurrent ectopic pregnancy.