【摘要】 目的探讨输卵管重复异位妊娠(REP)危险因素及临床特点。方法纳入北京协和医院2013年1月至2014年12月共78例REP组患者,并按首次异位妊娠(EP)年龄、婚姻状态、就业状态,以1∶1比例匹配77例同期收治初次治疗输卵管异位妊娠(SEP)患者作为SEP组,比较两组的临床特点,并分析REP的危险因素。结果未生育(OR=2.163,95%CI 1.066~4.386)、既往EP开腹手术史(OR=8.585,95%CI 1.001~73.596)是REP的危险因素。REP与SEP临床表现相似,除了REP组术前超声直径>4cm异位妊娠包块数较SEP组明显减少(P<0.01)。REP组术中发现合并粘连及对侧输卵管病变的发生率明显高于SEP组(P<0.05)。结论积极防治首次异位妊娠、合理避孕、采用腹腔镜手术可预防REP发生。更多还原

【Abstract】 Objective To study the risk factors and clinical features of recurrent tubal ectopic pregnancy(REP).Methods A retrospective case-control study was performed in 78 REP and 77 single ectopic pregnancy(SEP)patients matched at a ratio of 1∶1 with respect to age of initial EP,marital and employment status between January 2013 to December 2014 from Peking Union Medical College Hospital. Results Nonparous women(OR=2.163,95% CI1.066-4.386)and previous laparotomy surgery for initial EP patients(OR=8.585,95% CI 1.001-73.596)were more likely to suffer REP.Clinical features were similar between REP and SEP,except that REP patients had less adnexal mass >4cm on ultrasound(P<0.01).Surgical findings showed that REP had more pelvic adhesion and contralateral tubal disorders(P<0.05). Conclusion Active prevention for primary EP,effective contraceptive methods and laparoscopic surgeryareproposedto reduce the riskof REP.更多还原