CAJ | 학술논문

目的分析重复性异位妊娠(REP)的高危因素,提高对REP的认识及预防REP的发生.方法采用回顾分析方法,对北大人民医院5年来手术治疗的87例REP患者(观察组)的首次异位妊娠的治疗方法与REP部位进行了回顾性分析,并与同期收治的570例手术治疗的初次异位妊娠患者(对照组)的临床数据为对照,观察两组患者盆腔情况、既往病史等与REP发病的关系.结果87例REP者,59.8﹪发生于初次异位妊娠保守治疗后,共52例,其中同侧REP32例,对侧REP20例;40.2﹪发生于患侧输卵管切除后,共35例,其中同侧输卵管残端妊娠2例,对侧REP33例.两组间有显著差异(p<0.01).两组病例对比,观察组既往盆腔手术史、术中发现盆腔粘连、子宫内膜异位症及对侧输卵管病变明显高于对照组(p<0.05).结论首次异位妊娠的治疗方法与REP的发生及部位密切相关,盆腔手术史、盆腔粘连、子宫内膜异位症及对侧输卵管病变是REP发病的危险因素.
목적분석중복성이위임신(REP)적고위인소,제고대REP적인식급예방REP적발생.방법채용회고분석방법,대북대인민의원5년래수술치료적87례REP환자(관찰조)적수차이위임신적치료방법여REP부위진행료회고성분석,병여동기수치적570례수술치료적초차이위임신환자(대조조)적림상수거위대조,관찰량조환자분강정황、기왕병사등여REP발병적관계.결과87례REP자,59.8﹪발생우초차이위임신보수치료후,공52례,기중동측REP32례,대측REP20례;40.2﹪발생우환측수란관절제후,공35례,기중동측수란관잔단임신2례,대측REP33례.량조간유현저차이(p<0.01).량조병례대비,관찰조기왕분강수술사、술중발현분강점련、자궁내막이위증급대측수란관병변명현고우대조조(p<0.05).결론수차이위임신적치료방법여REP적발생급부위밀절상관,분강수술사、분강점련、자궁내막이위증급대측수란관병변시REP발병적위험인소.
Objective: Analyze the risk factors of Repeated Ectopic Pregnancy (REP), raise the consciousness of REP and take precautions against REP. Methods: A retrospective analysis about relations between treatment of first-time ectopic pregnancy and the position of REP was performed on the clinical data in the Peking University People’s Hospital and folow-up of 87 cases (Observation Group) of REP patients since 2007Compare contemporaneous 570 first-time REP patients (control group) who have surgical therapies with those cases showing above and find the relationship between morbidity of repeated ectopic pregnancy and, the anamnesis, the condition of pelvic cavities and so forth. Results: Among the 87 cases, 52 cases (59.8﹪ of total cases) occurred after first-time ectopic pregnancy expectant treatment, including 32 cases of ipsilateral REP and 20 cases of contralateral REP; 35 (40.2﹪) cases occurred after tubal resection, including 2 cases of ipsilateral REP and 33 cases of contralateral REP. The difference between these two groups is obvious (p<0.01). In comparison with the control group, observation group results in a significantly higher morbidity of repeated ectopic and has more risk to develop pelvic adhesion, endometriosis and contralateral tubal pathology (p<0.05). Conclusion: Treatment of first-time ectopic pregnancy is relevant to REP and the position of ectopic pregnancy. And, pelvic operation history, pelvic adhesion, endometriosis and contralateral tubal pathology are al risk factors of morbidity of repeated ectopic pregnancy.