国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2017, Vol. 36 ›› Issue (4): 340-344.

• 综述 • 上一篇    下一篇

异位妊娠患者保留生育功能的治疗策略及预后

彭超，周应芳   

  1. 100034  北京大学第一医院妇产科
  • 收稿日期:2017-04-05 修回日期:2017-06-13 出版日期:2017-07-15 发布日期:2017-07-15
  • 通讯作者: 周应芳，E-mail：zhouyf8853@163.com E-mail:13661097766@163.com

The Treatment Strategy and Prognosis of the Patients with Ectopic Pregnancy Who Desire Fertility

PENG Chao，ZHOU Ying-fang   

  1. Department of Obstetrics and Gynecology，Peking University First Hospital，Beijing 100034，China
  • Received:2017-04-05 Revised:2017-06-13 Published:2017-07-15 Online:2017-07-15
  • Contact: ZHOU Ying-fang，E-mail：zhouyf8853@163.com E-mail:13661097766@163.com

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摘要： 异位妊娠是妇科常见急腹症之一，治疗分为期待疗法、药物治疗和手术治疗三种方法。异位妊娠的处理趋向于保守治疗，其中以甲氨蝶呤（MTX）为主的药物治疗和腹腔镜手术为主流治疗方式。对输卵管妊娠患者只要对侧输卵管大致正常，输卵管开窗术或切除术对日后生育力影响相似。三种方法适应证选择恰当，治疗成功后患者两年内宫内孕率相似。剖宫产术后子宫瘢痕妊娠近年来明显增多，中国2016年已经出台相应专家共识可参考使用。

关键词: 妊娠, 异位, 治疗, 生育力, 甲氨蝶呤, 腹腔镜

Abstract: Ectopic pregnancy remains one of gynecological emergency. Treatment of this disease includes expectant management, medical treatment and surgical treatment, which  tends to be conservative. The medical treatment as methotrexate (MTX) and laparoscopic surgery are the current mainstream treatment. For those patients with a healthy contralateral tube and a tubal pregnancy, the subsequent fertility rates after salpingectomy and salpingotomy are similar in the long term. The two years intrauterine pregnancy rates are similar regardless of the treatment methods. Cesarean scar pregnancies are becoming more and more common in recent years. The experts consensus announced in 2016 can be referred in the treatment of cesarean scar pregnancy.

Key words: Pregnancy, ectopic, Therapy, Fertility, Methotrexate, Laparoscopes