输卵管妊娠腹腔镜下开窗取胚术与药物保守治疗对输卵管再通及妊娠率的临床价值分析  

Analysis of Clinical Value of Oviducal Pregnancy Laparoscopic Windowing for Embryo Extraction and Drug Conservative Treatment of Fallopian Tube Recanalization and Pregnant Rates

作　　者：王庭钊 

机构地区：[1]福建医科大学附属泉州第一医院妇产科,福建泉州362000

出　　处：《中外医疗》2017年第31期46-48,共3页China & Foreign Medical Treatment

摘　　要：目的比较腹腔镜下开窗取胚术与药物保守治疗用于输卵管妊娠的临床效果及对再通和妊娠率的影响。方法方便选取该院于2015年6月—2016年5月期间收治的112例输卵管妊娠患者,随机分为观察组和对照组,各56例。观察组采取腹腔镜输卵管开窗术治疗,对照组采取甲氨蝶呤肌注。比较两组临床表现。结果 (1)观察组患者平均β-HCG恢复时间为(10.1±4.7)d、包块消失时间为(6.4±4.9)d,均明显短于对照组;住院时间以及月经恢复时间也明显短于对照组(P<0.05)。(2)治疗后,观察组输卵管再通率达91.7%,对照组仅60.7%(P<0.05)。同时,观察组异位妊娠和主动避孕患者例数差异无统计学意义,但宫内妊娠的患者明显多于对照组(P<0.05)。(3)观察组治愈率高达100.0%,显著高于对照组的71.4%(P<0.05)。结论腹腔镜下开窗取胚术具有术后输卵管再通率、妊娠率高等优势,恢复更快,值得临床推广应用。Objective To compare the clinical value of oviducal pregnancy laparoscopic windowing for embryo extraction and drug conservative treatment of fallopian tube recanalization and pregnant rates. Methods 112 cases of patients with tubal pregnancy admitted and treated in our hospital from June 2015 to May 2016 were conveniently a selected and divided into two groups with 56 cases in each, the observation group and the control group were respectively treated with laparoscopic windowing, while the control group adopted the intramuscular injection of methotrexate, and the clinical manifestations were compared between the two groups. Results The average β-HCG recovery time and mass disappearance time in the observation group were respectively(10.1±4.7)d and(6.4±4.9)d, which were obviously shorter than those in the control group, and the length of stay and menstruation recovery time were obviously shorter than those in the control group(P<0.05),after treatment, the fallopian tube recanalization rate in the observation group and in the control group was respectively 91.7%and 60.7%(P<0.05), and there were no obvious differences in the ectopic gestation and active contraception, but the patients with intrauterine pregnancy were obviously more than those in the control group(P<0.05), the cure rate in the observation group was obviously higher than that in the control group(100.0% vs 71.4%)(P<0.05). Conclusion The laparoscopic windowing for embryo extraction has the advantages of high postoperative fallopian tube recanalization and pregnant rates, and the recovery is faster, which is worth promotion and application.

关 键 词：腹腔镜 输卵管开窗术 输卵管妊娠 

分 类 号：R5[医药卫生—内科学]