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目的探讨重复异位妊娠(REP)的病因及治疗方法。方法回顾性分析2013年10月-2015年10月该院收治的REP患者58例(REP组),并选取该院同期收治的58例首次异位妊娠患者作为对照组,分析首次异位妊娠患者治疗方式与REP发生的关系以及REP患者的治疗方式。结果 REP患者的年龄、妊娠次数、流产次数、盆腔手术史及盆腔粘连情况显著高于首次异位妊娠患者(P<0.05),同时停经时间、首次β-人绒毛膜促性腺激素(β-hCG)值均低于首次异位妊娠患者(P<0.05),而两组患者间产次、阴道流血时间、腹痛及人工流产史比较,差异均无统计学意义(P>0.05);前次异位妊娠行患侧输卵管切除术的41例患者中,本次异位妊娠发生在同侧者2例(4.88%),对侧者39例(95.12%),而行保守治疗的17例患者中发生在同侧者16例(94.12%),对侧者1例(5.88%),两者比较,差异有统计学意义(P=0.000);58例REP患者中行腹腔镜手术、开腹手术及药物治疗者分别为19例(32.76%)、18例(31.03%)及21例(36.21%),而首次异位妊娠患者中分别为25例(43.10%)、15例(25.86%)及18例(31.03%),两组患者3种治疗方式间比较,差异无统计学意义(P=0.516)。结论患者的年龄、妊娠次数、流产次数、盆腔手术史、盆腔粘连、停经时间及首次β-hCG值与REP存在密切联系,首次异位妊娠的治疗方式对REP发病部位存在一定影响。
Objective To investigate the etiology and treatment of repeated ectopic pregnancy (REP). Methods Retrospective analysis of 58 cases (REP group) of REP patients admitted from October 2013 to October 2015 in our hospital and 58 cases of the first ectopic pregnancy treated in the same period of the hospital as the control group were analyzed. The relationship between the treatment modalities and the occurrence of REP and the treatment of patients with REP. Results The age of patients, the number of pregnancy, the number of abortions, the history of pelvic surgery and the pelvic adhesions in patients with REP were significantly higher than those in patients with ectopic pregnancy (P <0.05), meanwhile menopause time, β-hCG ) Were lower than those of the first ectopic pregnancy (P <0.05). There was no significant difference between the two groups in the time of delivery, vaginal bleeding, abdominal pain and abortion (P> 0.05) Of the 41 patients who underwent tubal resection in pregnancy, the ectopic pregnancy occurred in 2 cases (4.88%) on the ipsilateral side and 39 cases (95.12%) on the contralateral side in 17 patients who underwent conservative treatment There were 16 cases (94.12%) in the same side and 1 case (5.88%) in the contralateral side, the difference was statistically significant (P = 0.000); 58 cases of REP patients underwent laparoscopic surgery, laparotomy and Nineteen patients (32.76%), 18 patients (31.03%) and 21 patients (36.21%) were treated with drugs, while 25 patients (43.10%), 15 patients (25.86%) and 18 (31.03%). There was no significant difference between the three treatment methods in the two groups (P = 0.516). Conclusions The age, number of pregnancies, number of abortions, pelvic surgery history, pelvic adhesions, menopause time and the first β-hCG values are closely related to REP. The treatment of the first ectopic pregnancy has some influence on the pathogenesis of REP.