The Correlational Study For Pathogens Of STD In Low Gential Trace In Tubal Pregnancies And Recanalization Of Tubal Post-operation

Objective:To study the distribution of pathogens of sexually transmitted disease(STD) in tubal pregnant patients' lower genital tract. To discuss the relationship between lower genital tract infection of pathogenic microorganisms and tubal pregnancy, The drug sensitivity test can offer evidence for clinical drug usage, decreasing the persistent infection of pathogens and reducing the recurrence rate of tubal pregnancy.Methods:Cervical secretion samples were used to culture and detect neisseria gonorrhoeae(NG), chlamydia trachomatis(CT) and ureaplasma urealyticum(UU) in 135 patients with tubal pregnancy(experiment group),and drug sensitivity to the UU positive patients. At the same time probe clinical pathological characters of the tubal tissuses. Follow up to evaluate the outcome in some patients with positive of CT and UU after three months postoperation throuth hystero-salpingogram(HSG) in tubal pregnancy patient. Comparing with 68 non- tubal pregnancy patients (control group).Results:1. In the 135 tubal pregnancy patients, the detective rate of CT was 19.3%(26/135), UU was 40.7%(55/135), CT with UU was 8.9%(12/135), NG was 3.7%(5/135),. The infected rate of CT, UU and CT with UU in the tubal pregnancy group was significant higher than control group, X2 values were 8.1,10.9 and 4.9, P values were 0.004,0.001 and 0.026;2. Among 23 patients with repeated tubal pregnancy, the positive rate of CT and CT with UU was 34.8% and 21.7%, was significantly higher than those only one time tubal pregnancy, X2 values were 4.3and 5.7, P values were 0.038 and 0.017;3. UU is different to the drug sensitivity, UU is more sensitive to doxycycline, josamycin and clarithromycin, but resistant to ofloxacin and roxithromycin;4. With positive CT and UU in the tubal pregnancy groups, there were 80.8% and 76.4% patients have pelvic adhesion; pathological changes of tube are mainly chronic nonspecific inflammation, in experiment group, the proportion of pathological changes and paramorphia of tube were 84.4% and 80.7%, significant higher than control group, X2 values were 112 and 95, both P values were 0.000;5.25 tubal pregnancy patients with CT and UU infection after 3 months post-operation through HSG, UU infected recanalized rate is 77.8%, CT infected recanalized rate is 57.1%, no significant difference between them (X2=1.1, P=0.355).Conclusion:1. Tubal pregnancy is related to STD; The pathogens are mainly CT and UU, very few cases of NG infection;2. Fallopian tube of tubal pregnancy showed a chronic inflammatory change; postoperative follow-up after three months of regular treatment for CT and UU, most patients' tubal can be recanalized;3. The detection of STD pathogens as a routine examination of ectopic pregnancy patients, can help to definite the pathogen of infection.