腹腔镜手术治疗宫内外同时妊娠21例临床分析  

Clinical Analysis of 21 Cases of Heterotopic Pregnancy treated by Laparoscopic Surgery

作　　者：邓凯贤[1] 郑玉华[1] 柳晓春[1] 

机构地区：[1]广东省佛山市妇幼保健院,广东佛山528000

出　　处：《实用妇产科杂志》2011年第11期841-844,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:评估腹腔镜手术在宫内外同时妊娠(HP)诊断和治疗中的价值,探讨对HP患者实施腹腔镜手术的手术技巧。方法:回顾性分析2003～2010年在我院接受腹腔镜手术治疗的21例HP患者的临床资料。结果:21例患者中有20例为输卵管妊娠(均行患侧输卵管切除术),1例为宫角妊娠(行宫角妊娠取出术)。部分患者同时行盆腔粘连松解术和(或)对侧输卵管结扎术。所有手术均经腹腔镜顺利完成,无中转开腹,无术中重大并发症发生。术后有20例患者接受不同时间的保胎治疗,17例成功分娩,1例怀孕8个月,2例保胎失败,保胎成功率达90.0%(18/20)。结论:腹腔镜手术不仅可早期确诊可疑HP患者,减少异位妊娠对宫内胚胎的影响,还可同时对异位妊娠进行有效治疗,对休克型及少见的HP的治疗亦安全可行。腹腔镜手术是治疗HP的理想手术方式。Objective： To evaluate the efficency and safety of laparoscopic surgery in the diagnosis and treatment of heterotopic pregnancy（HP）, and to discuss the operation techniques of laparoscopy in HP patients. Methods：21 cases of heterotopic pregnancy treated by laparoscopy in Maternal and Children＇s Hospital of Foshan from 2003 to 2010 were retrospectively analyzed. Results ：20 of 21 cases were fallopian tube pregnancies（ Salpingectomy was performed）, one case was uterine cornua pregnancy （cornuectomy was performed ）. Adhesiolysis and（or） tubal ligation of uninjured side was performed in some patients. All operations were finished laparoscopically without any major complications. 20 patients had different time span tocolytic treatment postopetatively, 17 patients had successful delivary, one patient was in pregnancy for 8 month, 2 patients lost their babies. The success rate of preserving fetus was 90.0%. Conclusions： Laparoscopic surgery can diagnose and treat HP at early stage, thus reduce the impact of ectopic pregnancy on in- trauterine pregnancy. It＇s feasible and safe for rare HP or HP with shock. Laparoscopy is the ideal method to treat heterotopic pregnancy.

关 键 词：宫内外同时妊娠 腹腔镜 手术 

分 类 号：R713.8[医药卫生—妇产科学]