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目的：分析比较三种输卵管妊娠治疗后宫内妊娠、再次异位妊娠发生情况。方法：对６８例输卵管妊娠有生育要求患者，给予保守性手术治２８例，宫腔镜下插管注氨甲蝶呤（ＭＴＸ）治疗１８例，单次肌肉注射氨甲蝶呤（ＭＴＸ）治疗２２例。结果：６８例治疗后４５例宫内妊娠，５例再次异位妊娠，其中保守性手术后宫内妊娠２０例，妊娠率７１．４％，宫腔镜下插管注ＭＴＸ后宫内妊娠１３例，妊娠率７２．２％，单次肌肉注射ＭＴＸ后宫内妊娠１２例，妊娠率５４．５％，后者妊娠率明显低于前两者，且再次异位妊娠发生率高于前两者。结论：输卵管妊娠治疗后输卵管通畅是宫内妊娠的条件，防止、减少治疗后粘连及积极治疗炎症，是提高妊娠率，减少再次发生异位妊娠的关键。
OBJECTIVE: To analyze and compare the intrauterine pregnancy after three tubal pregnancy treatments and the occurrence of ectopic pregnancy again. Methods: 68 cases of tubal pregnancy with fertility requirements were given conservative surgery in 28 cases, hysteroscopic injection of methotrexate (MTX) in 18 cases, a single intramuscular injection of methotrexate (MTX) treatment 22 cases. Results: Among the 68 cases, 45 cases were intrauterine pregnancy and 5 cases were ectopic pregnancy again. Among them, 20 cases were intrauterine pregnancy after conservative operation, the pregnancy rate was 71.4%, hysteroscopic intrathecal injection of MTX intrauterine pregnancy was 13 cases . The pregnancy rate was 72.2%. Twelve intrauterine pregnancies were intramuscularly injected with MTX, the pregnancy rate was 54.5%. The latter pregnancy rate was significantly lower than the former two, and the incidence of ectopic pregnancy was higher than the former two. Conclusion: Tubal pregnancy after tubal patency is intrauterine pregnancy conditions, to prevent and reduce postoperative adhesions and active treatment of inflammation is to improve the pregnancy rate and reduce the recurrence of ectopic pregnancy key.