腹腔镜下两种不同术式治疗宫角妊娠的临床疗效分析  

Clinical effects of two different laparoscopic operative types on treating cornual pregnancy

作　　者：黄伟容[1] 赵仁峰[1] 吴玉英[1] 封意兰 

机构地区：[1]广西壮族自治区人民医院妇科,南宁530021

出　　处：《中国临床新医学》2017年第11期1055-1058,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的分析腹腔镜下两种不同术式治疗宫角妊娠的临床疗效。方法回顾性分析2010-01~2014-06该院收治46例宫角妊娠患者行腹腔镜手术治疗的临床资料,根据术式分为宫角妊娠部位楔形切除缝合肌层修补术组(切除组,n=19)和宫角妊娠部位病灶切开取胚并缝合修补切口组(切开组,n=27),比较两组术前、术中、术后情况。结果两组的术中所见、术后恢复情况参数比较差异均无统计学意义(P>0.05),切除组手术时间、术中出血量多于切开组,差异有统计学意义(P<0.05)。术后输卵管造影结果提示切开组的病灶同侧输卵管通畅情况好于切除组,差异有统计学意义(P<0.05),对侧输卵管通畅情况及术后盆腔粘连情况差异均无统计学意义(P>0.05)。结论腹腔镜下两种不同术式治疗宫角妊娠均可达到治愈目的,宫角楔形切除术可能增加术后输卵管堵塞风险,有待临床实践中进一步研究。Objective To explore the clinical effects of two different laparoscopic operative types on treating cornual pregnancy. Methods A retrospective analysis of clinic data of 46 patients with cornual pregnancy who underwent operations by two different laparoscopic operative types was performed. The patients were collected from the People＇s Hospital of Guangxi Zhuang Autonomous Region during January 2010 and June 2014,and were divided into the cornual pregnancy site wedge resection group（ resection group,n = 19） and the cornual pregnancy site dissection and removing embryo group（ dissection group,n = 27）. The preoperative conditions,the surgical parameters were compared between the two groups during and after the operation. Results There were no significant differences in the surgical parameters during and after the operation between the two groups（ P 0. 05）,but the operation time and the amount of bleeding during the operation in the resection group were significantly shorter or less than those in the dissection group（ P 0. 05）. Salpingography showed that tubal patency improved better in the dissection group than in the resection group（ P 0. 05）. There were no significant differences in the contralateral tube and pelvic adhesion postoperatively between the two groups（ P 0. 05）. Conclusion Both of laparoscopic cornual pregnancy site wedge resection and cornual pregnancy site dissection and removing embryo are effective for treating cornual pregnancy,and the former operative type may increase the obstructive risk of ipsilateral tube.

关 键 词：宫角妊娠 腹腔镜 楔形切除 取胚 输卵管堵塞 

分 类 号：R714.2[医药卫生—妇产科学]