输卵管妊娠腹腔镜保守性手术后持续性异位妊娠的相关因素分析

目的 探讨输卵管妊娠腹腔镜保守性手术后持续性异位妊娠(persistent ectopic pregnancy,PEP)的相关因素和防治措施.方法 回顾性分析2004-01～2010-12行腹腔镜下输卵管妊娠保守性手术635例患者的临床资料.结果 PEP的发生与停经时间、妊娠包块直径、术前血清β-HCG水平、手术方式、有无输卵管妊娠史、术中是否行黄体剥除等因素相关(P<0.05或P<0.01);与腹腔内出血量及有无盆腔粘连无关.结论 了解PEP的高危因素,严格掌握手术适应证,提高手术技巧,能够降低PEP的发生率.

A analysis on related factors of persistent ectopic pregnancy after conservative operation of tubal pregnancy under laparoscope

Objective To explore risk factors,prevention and operating technique of persistent ectopic pregnancy (PEP) after conservative operation of tubal pregnancy under laparoscope.Methods The clinical data of 635 cases who were treated with conservative operation of tubal pregnancy under laparoscope in our hospital from January 2004 to December 2010 was retrospectively analyzed.Results The PEP rate was significantiy related to the time of the cessation of menstruation and the diameter of ectopic mass,the level of HCG in blood before operation,operation methods,the medical history of tubal pregnancy,the PEP rate of patients undewent ovarian luteal surgery during conservative operation of tubal pregnancy under laparoscope and so on(P<0.05 or<0.01),and was not related to intraperitoneal bleeding loss volume and pelvic adherence.Conclusion Realizing the risk factors of PEP,controlling the operation indication restrictedly and investigating operating technique can inhibit the occurrence of PEP effectively.