腹腔镜下输卵管切开取胚术治疗输卵管间质部妊娠的疗效观察  

The observation of the clinical efficacy of laparoscopic cornuotomy in the treatment of interstitial tubal pregnancy

作　　者：陈晶晶 吕姜敏 李金晶 郑建琼 Chen Jingjing

机构地区：[1]浙江中医药大学,310053 [2]上海大学附属第三医院(温州市人民医院),325000

出　　处：《浙江临床医学》2022年第5期660-662,665,共4页Zhejiang Clinical Medical Journal

基　　金：温州市科技计划项目(2020Y0976)。

摘　　要：目的 评价腹腔镜下输卵管切开取胚术治疗输卵管间质部妊娠的疗效.方法 2017年1月至2020年12月因输卵管间质部妊娠行腹腔镜手术患者83例,其中行腹腔镜输卵管间质部切开取胚+缝合术为切开取胚组(n=25),行腹腔镜下宫角楔形切除+缝合术为宫角楔形切除组(n=58).结果 切开取胚组与宫角楔形切除组手术时间[(83.86±23.00 VS.62.05±7.56)min]、术中出血量[(75.44±5.62 VS.76.82±29.87)mL]、术后24 hβ-hCG较术前下降率[0.62(0.58,0.73)%VS.0.66(0.57,0.72)%],术后并发症[(2 VS.5)例],差异无统计学意义(P>0.05).切开取胚组术后未发生持续性宫外孕,未发生子宫破裂情况.输卵管间质部妊娠包块直径>3 cm行腹腔镜下输卵管切开取胚有5例,行腹腔镜下宫角楔形切除有19例,切开取胚组与宫角楔形切除组比较:手术时间[(84.60±7.79 VS.9.55±8.71)min]、术中出血量[(82.0±18.0 VS.99.41±27.14)mL]、术中MTX使用情况[(3 VS.2)例]、术后24 hβ-hCG较术前下降率[0.62(0.77,0.83)%VS.0.63(0.55,0.74)%],术后并发症[(0 VS.2)例]、持续性异位妊娠[(0 VS.1)例],差异无统计学意义(P>0.05).结论 腹腔镜下切开取胚术治疗输卵管间质部妊娠疗效满意,可在临床中推广.Objective To investigate the clinical eficacy of laparoscopic cormuotomy on intersttial tubal pregmancy.Methods The women who were selected from January 2017 to December 2020 at the Department of Gynecology,W enzhou People's Hospital.A total of 83 IP patients were divided into two groups.They were all treated with laparoscopic surgery.25 patients were conducted by a cornuotomy and suturing the cornual.58 patients were conducted by a cornual resection and suturing the cornual.The peri-surgical data and the related clinical data were compared in cornuotomy and cornual resection group.Results The operative time[(83.86±23.0 VS.62.05±7.56)min],intraoperative blood loss[(75.44±5.62 VS.76.82±29.87)mL],decreased rate ofβ-hCG at first 24 hours after operation[0.62(0.58,0.73)%VS.0.66(0.57,0.72)%],and postoperative complications[(2 VS.5)persons],were not significantly different between the two groups(P>0.05).There were no persistent ectopic pregnancy and uterine rupture happened in two groups.With a diameter of more than 3 cm,there were 5 cases of cornuotomy and 19 cases of cornual resection.The operative time[(84.60±7.79 VS.9.55±8.71)min],intraoperative blood loss[(82.0±18.0 VS.99.41±27.14)mL],the use of MTX[(3 VS.2)persons],decreased rate ofβ-hCG at first 24 hours afer operation[0.62(0.77.0.83)%VS.0.63(0.55.0.74)%].the postoperative[(0 VS.2)persons]and persistent ectopic pregnancy complications[(0 VS.1)persons] were not significantly different between the two groups(P>0.05).Conclusion The Laparoscopic cornuotomy is feasible and safe on interstitial tubal pregnancy,and it deserves popularization in the clinical work.

关 键 词：输卵管间质部妊娠 腹腔镜手术 切开取胚 宫角切除 

分 类 号：R71[医药卫生—妇产科学]