腹腔镜下治疗输卵管妊娠不同术式的研究  

Laparoscopy in different surgery for tubal pregnancy

作　　者：要慧萍[1] 

机构地区：[1]酒泉市人民医院,甘肃酒泉735000

出　　处：《腹腔镜外科杂志》2009年第5期382-384,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜不同手术方式治疗输卵管妊娠的安全性及治疗效果。方法:回顾分析2000年1月至2008年12月我院为236例希望保留生育功能并有随诊条件的输卵管妊娠患者行腹腔镜手术的临床资料。根据手术方式进行分组,A组124例,行输卵管开窗缝合术及输卵管内胚物取出术,患侧输卵管近端注射甲氨蝶呤50mg;B组112例,为对侧输卵管外观正常或无法保留患侧输卵管的患者,行输卵管切除术。比较两组术后宫内妊娠率和再次异位妊娠的风险。结果:术后1～2年内宫内妊娠率A组78例(62.97%),B组58例(51.8%),两组差异有统计学意义(P<0.05);再次异位妊娠发生率A组7例(5.6%),B组5例(4.5%),差异无统计学意义(P>0.05)。结论:输卵管妊娠行腹腔镜保留患侧输卵管手术微创、安全、有效,术后恢复快。宫内妊娠率高于输卵管切除者,更适于未生育的患者,不增加再次宫外孕发生的危险。Objective：To explore the safety and effect of laparoscopy in different surgery for tubal pregnancy. Methods：From Jan. 2000 to Dec. 2008 236 patients with tubal pregnancy, who wanted to preserve fertility and could be followed up, underwent laparoscopy in our hospital. The clinical data of them were analyzed retrospectively. The patients were divided according to operative method. There were 124 patients in group A ,who underwent oviduct fenestration, removal of embryo and injection of 50mg MTX in the proximal end of affected oviduct. The 112 patients in group B,with normal appearance of contralateral oviduct or could not preserve affected oviduct,underwent tubal pregnancy. The postoperative rate of intrauterine gestation and risk of ectopic re-pregnancy between two groups were compared. Results：The rate of intrauterine gestation was 62.97% （78 cases） in group A and 51.8% （58 cases） in group B,the difference was significant（P 〈0.05）. The rate of ectopic re-pregnancy was 5.6% （7 cases） in group A and 4.5% （5 cases） in group B,the difference was not significant（ P 〉 0.05 ）. Conclnsions：The laparoscopic affected oviduct conservative surgery is mini-invasive, safe, effective ,with quicker recovery. The rate of intrauterine gestation is higher than the other group, suitable for patients who have not given birth, and doesnt increase the risk of ectopic re-pregnancy.

关 键 词：腹腔镜术 输卵管妊娠 对照研究 

分 类 号：R713.8[医药卫生—妇产科学]