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目的:分析腹腔镜下输卵管妊娠保守性手术后持续性异位妊娠的因素。方法:对2010年1月～2011年1月145例输卵管妊娠腹腔镜下保守性手术患者进行回顾性分析。结果:145例输卵管妊娠腹腔镜下保守性手术患者中发生PEP者19例,发生率为13.1%。PEP组有异位妊娠史者明显高于非PEP组(P<0.05),住院时间长于非PEP组(P<0.05),术前β-HCG水平明显高于非PEP组,黄体切除率明显低于非PEP组,盆腔粘连发生率明显高于非PEP组(P<0.05),而两组年龄、停经时间和包块直径方面比较差异无统计学意义(P>0.05)。结论:输卵管妊娠腹腔镜保守性手术后PEP的发生与患者的异位妊娠史、术前血β-HCG水平、黄体切除和盆腔粘连密切相关,术后监测血β-HCG水平的变化有利于早期发现和预防PEP的发生。
Objective: To analyze the factors of persistent ectopic pregnancy after laparoscopic conservative surgery of tubal pregnancy. Methods: A retrospective analysis of 145 cases of tubal pregnancy under laparoscopic conservative surgery from January 2010 to January 2011 was performed. Results: Of the 145 cases of tubal pregnancy undergoing laparoscopic conservative surgery in 19 patients with PEP, the incidence was 13.1%. The history of ectopic pregnancy in PEP group was significantly higher than that in non-PEP group (P <0.05), and the length of hospital stay was longer than that in non-PEP group (P <0.05). The preoperative β-HCG level was significantly higher than that of non-PEP group and the corpus luteum resection rate was significantly lower In non-PEP group, the incidence of pelvic adhesions was significantly higher than that of non-PEP group (P <0.05), but there was no significant difference between the two groups in age, menopause time and mass diameter (P> 0.05). Conclusions: The occurrence of PEP after laparoscopic conservative surgery for tubal pregnancy is closely related to the history of ectopic pregnancy, blood β-HCG level, corpus luteum resection and pelvic adhesions in patients with tubal pregnancy. The change of postoperative β-HCG level in blood is in favor of early stage Discover and prevent the occurrence of PEP.