【摘要】 目的　探讨重复异位妊娠发生的相关因素。方法　采用回顾性临床研究方法 ,对 2 8例重复异位妊娠患者 (观察组 )首次异位妊娠的临床资料进行回顾性分析 ,并以同期收治的 5 6例初次异位妊娠患者 (对照组 )的临床资料为对照 ,观察两组患者发病时年龄、结婚年龄、孕次、产次、避孕方式、停经天数、阴道出血天数、血 β人绒毛膜促性腺激素 (β humanchorionicgonadotropin ,β hCG)最高值、腹腔内出血量、异位妊娠类型、治疗方式和输卵管有无炎症表现等。应用Logistic回归分析方法筛查重复异位妊娠发生的相关因素。结果　多变量分析重复异位妊娠发生的危险因素及比数比 (OR)值为 :治疗方式为输卵管吻合 (OR =6 2 74 ,P =0 0 4 3)、输卵管炎症表现 (OR =5 4 85 ,P =0 0 0 0 )、无避孕措施 (OR =11 2 9,P =0 0 0 2 )和避孕措施为不严格阴茎套 (工具 )避孕 (OR =4 75 ,P =0 0 4 6 ) ;保护性因素OR值为 :治疗方式为输卵管切除加对侧绝育 (OR =0 0 6 ,P =0 0 4 9)、口服避孕药避孕 (OR =0 10 ,P =0 0 5 0 )和治疗方式为药物保守治疗 (OR =0 33,P =0 0 0 2 )。结论　输卵管吻合术、输卵管炎症表现、无避孕措施和不严格工具避孕 ,为重复异位妊娠发生的危险因素 ,治疗方式为输卵管切除加对侧绝育、口服?更多还原

【Abstract】 Objective To determine the relative factors of the onset of repeated ectopic pregnancy. Methods The clinical data of the first time ectopic pregnancy of 28 cases with repeated ectopic pregnancy were analysed, and compared with those of 56 cases of non-repeated ectopic pregnancy onsetting at the same period. The factors measured included: age at onset of disease, age at first coitus, gravidity, parity, methods of contraception, duration of amenorrhea,duration of vaginal bleeding, serum β-human chorionic gonadotropin level, volume of intraperitoneal bleeding, types of ectopic pregnancy, methods of therapy and inflammation evidence of fallopian tube. Logistic regression analysis was performed to determine the relative factors for onset of repeated pregnancy. Results The risk factors and its odds ratio (OR) from the multivariate analysis were as follow: anastomosis of the tube(62.74, P=0.043), positive evidence of inflammation of the tube (54.85, P=0.000), no contraception (11.29, P=0.002), contraception by condom occasionally (4.75, P=0.046); the protective factors and its OR were as follow: therapy being salpingectomy and sterilization of the opposite tube(0.06, P=0.049), oral contraception (0.10, P=0.050) and pharmacotherapy (0.33, P=0.002). Conclusions The risk factors of onset of repeated ectopic pregnancy include: anastomosis of the tube, positive evidence of inflammation of the tube, no contraception and contraception by condom occasionally; the protective factors include: therapy being salpingectomy and sterilization of the opposite tube, oral contraception and pharmacotherapy.更多还原