CAJ | 학술논문

目的：比较不同治疗方案下输卵管患者的妊娠结局。方法回顾性分析2010年2月至2014年1月间来我院治疗的918例输卵管妊娠且有生育要求的患者病例，其中手术治疗有560例（ A组），选择药物治疗231例（ B组），期待疗法127例（ C组）。观察并比较三组患者治疗后患侧输卵管复通情况，并对病例电话随访，了解治疗后妊娠结局情况，子宫内妊娠、异位妊娠、继发性不孕。结果 A组输卵管畅通率优于B、C组；C组输卵管畅通率优于B组，差异有统计学意义（P＜0．05）；三组患者子宫内妊娠率A组高于B、C组，B组高于C组，差异有统计学意义（P＜0．05）；再次异位妊娠三组发生率差别有统计学意义（P＜0．05），B组最高，其中A组、C组间发生率差别无统计学意义（P＞0．05）；三组患者继发性不孕发生率A组低于B组低于C组，差别均有统计学意义（P＜0．05）；不同手术方式治疗的输卵管妊娠患者子宫内妊娠、再次异位妊娠、继发不孕发生率相比，差异均有统计学意义（P＜0．05），腹腔镜组高于开腹手术组。结论异位妊娠的患者治疗手术治疗效果最好，再次妊娠率较高，其中腹腔镜手术效果优于开腹手术，且创伤较小，风险较低，痛苦少，可作为首选的治疗方式。
목적：비교불동치료방안하수란관환자적임신결국。방법회고성분석2010년2월지2014년1월간래아원치료적918례수란관임신차유생육요구적환자병례，기중수술치료유560례（ A조），선택약물치료231례（ B조），기대요법127례（ C조）。관찰병비교삼조환자치료후환측수란관복통정황，병대병례전화수방，료해치료후임신결국정황，자궁내임신、이위임신、계발성불잉。결과 A조수란관창통솔우우B、C조；C조수란관창통솔우우B조，차이유통계학의의（P＜0．05）；삼조환자자궁내임신솔A조고우B、C조，B조고우C조，차이유통계학의의（P＜0．05）；재차이위임신삼조발생솔차별유통계학의의（P＜0．05），B조최고，기중A조、C조간발생솔차별무통계학의의（P＞0．05）；삼조환자계발성불잉발생솔A조저우B조저우C조，차별균유통계학의의（P＜0．05）；불동수술방식치료적수란관임신환자자궁내임신、재차이위임신、계발불잉발생솔상비，차이균유통계학의의（P＜0．05），복강경조고우개복수술조。결론이위임신적환자치료수술치료효과최호，재차임신솔교고，기중복강경수술효과우우개복수술，차창상교소，풍험교저，통고소，가작위수선적치료방식。
Objective To explore the reproductive of different management strategies of tubal pregnancy . Methods 918 patients diagnosed as tubal pregnancy were selected between February 2010 and January 2014, in accordance with the wishes of patients into three groups for treatment , surgical treatment, 560 cases (group A), select drugs in the treatment of 231 cases ( group B ) , expectant treatment , 127 cases ( group C ) , observe and compare the three groups of patients experienced side oviduct after treatment , and the cases of telephone follow-up, understand the pregnancy outcome after treatment , intrauterine pregnancy and ectopic pregnancy , secondary infertility.Results Fallopian tube flow rate of group A was better than that of group B and C;Fallopian tube flow rate is better than that of group B, group C difference was statistically significant (P<0.05); Three groups of patients with intrauterine pregnancy rate in group A than group B , C, group B was higher than C group , the difference was statistically significant ( P <0.05 ); Incidence of ectopic pregnancy again three groups was statistically significant difference (P<0.05), group B was highest, of which the rate difference between group A and group C had no statistical significance (P>0.05);Three groups of patients with secondary infertility rates in group A than group B than in group C , the difference had statistical significance ( P<0.05); Different surgical treatment of tubal pregnancy patients with intrauterine pregnancy and ectopic pregnancy again , compared the incidence of secondary infertility, differences were statistically significant (P<0.05), laparoscopic group was higher than open surgery group .Conclusions Ectopic pregnancy patients with treatment of surgical treatment for the best effect , higher pregnancy rates again , which effect is superior to laparotomy , laparoscopic surgery and trauma is small, the risk is low, less painful, can be used as the preferred treatment .