宫腔镜与腹腔镜治疗早期输卵管妊娠的疗效比较  

Comparison of hysteroscopic and laparoscopic treatment for early tubal pregnancy

作　　者：邵华江[1] 马建婷[1] 周丽芳[1] 张海英[1] 

机构地区：[1]浙江省余姚市人民医院妇产科,余姚315400

出　　处：《中国微创外科杂志》2006年第1期54-56,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：宁波市医学科研项目(编号2003081)

摘　　要：目的比较宫腔镜与腹腔镜治疗早期输卵管妊娠的疗效，以寻求更简便、有效、微创的早期输卵管妊娠治疗方法。方法2002年3月～2005年4月，对符合药物保守治疗条件的145例（宫腔镜组）早期输卵管妊娠行宫腔镜下插管注射MTX，选择同期相同条件并要求保留生育功能行腹腔镜保守手术56例（腹腔镜组）进行疗效比较。结果血B-hCG、孕酮及月经恢复正常所需时间和术后住院时间宫腔镜组均明显长于腹腔镜组（t=6．187，P=0．000；t=8．277，P=0．000；t=3．840，P=0．000；t=2．454，P=0．015）。2组疗效、患侧输卵管通畅率、宫内妊娠率、异位妊娠率差异均无显著性（P〉0．05）；宫腔镜组医疗费用明显低于腹腔镜组（t=-85．584，P=0．000）。结论宫腔镜下插管注射MTX与腹腔镜保守手术相比．更简便、经济、微创．是可供选择的早期输卵管妊娠治疗方法。Objective To compare the curative effects between hysteroscopic and laparoscopic management for early tubal pregnancy. Methods Hysteroscopic tubal catheterization with methorexate （MTX） injection was performed in 145 cases of early tubal pregnancy from March 2002 to April 2005 （ Hysteroscopic Group）. Another group of 56 cases with the same diagnosis and childbearing demand was given laparoscopic conservative operation （Laparoscopic Group）. The curative effects of the two groups were compared. Results The recovery time of serum [~ - hCG, progesterone, and menstruation, and the postoperative hospital stay were significantly longer in the Hysteroscopic Group than in the Laparoscopic Group （ t = 6. 187, P = 0. 000 ; t = 8. 277, P = 0. 000 ; t = 3. 840, P = 0. 000 ; t = 2.454, P = 0. 015 ）. No significant differences were found in the curative effects, tubal patent rate, intrauterine pregnancy rate, and ectopic pregnancy rate between the two groups （ P 〉 0. 05）. The medical expenses of the Hysteroscopic Group was significantly lower than that of the Laparoscopic Group （t = - 85. 584, P = 0. 000）. Conclusions As compared with laparoscopic conservative operation, hysteroscopic tubal catheterization with MTX injection is another simple, cost - effective, and minimally invasive alternative for early tubal pregnancy.

关 键 词：宫腔镜 腹腔镜 输卵管妊娠 

分 类 号：R713[医药卫生—妇产科学]