腹腔镜下妊娠病灶清除术在Ⅱ型未破裂型宫角妊娠中的临床应用价值探讨  

An exploration on the clinical application value of laparoscopic debridement of pregnancy lesions in typeⅡunruptured corneal pregnancy

作　　者：杨扬繁 刘妮平[1] YANG Yangfan;LIU Niping(Department of Gynecology,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

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》2024年第11期1288-1291,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨腹腔镜下妊娠病灶清除术在Ⅱ型未破裂型宫角妊娠中的应用价值。方法选择2016年10月至2020年10月广西壮族自治区人民医院妇科收治的Ⅱ型未破裂型宫角妊娠患者20例。无胎心搏动15例;妊娠包块<3 cm者9例,≥3 cm者11例。均经B超及腹腔镜检查确诊,行腹腔镜下妊娠病灶清除术治疗。分析患者术中出血量、手术时间、并发症发生情况、手术前后人绒毛膜促性腺激素(HCG)、血红蛋白(Hb)的变化情况以及术后妊娠情况。结果20例患者手术时间为(78.70±28.78)min,术中出血量为(54.00±39.80)mL。术前胎心搏动情况对术中出血量、手术时间无显著影响(P>0.05)。术前妊娠包块<3 cm组的术中出血量少于妊娠包块≥3 cm组,差异有统计学意义(P<0.05),但两组手术时间比较差异无统计学意义(P>0.05)。20例患者术中均未出现子宫穿孔、周围脏器损伤等并发症。术后阴道流血时间为(4.45±1.85)d,术后恢复正常饮食时间为(3.30±0.87)d,术后住院时间为(4.00±0.65)d。患者术后2 d HCG和Hb水平较术前显著降低(P<0.05)。11例患者有妊娠意愿,其中6例(54.55%,6/11)再次正常妊娠并成功生产。结论针对Ⅱ型未破裂型宫角妊娠,腹腔镜下妊娠病灶清除术更好地保护了子宫内膜,并保留了子宫肌层的完整性,减少了再次手术风险,有一定的临床应用价值。Objective To explore the application value of laparoscopic debridement of pregnancy lesions in typeⅡunruptured corneal pregnancy.Methods Twenty patients with typeⅡunruptured corneal pregnancy who were admitted to the Department of Gynecology of the People′s Hospital of Guangxi Zhuang Autonomous Region from October 2016 to October 2020 were selected.There were 15 cases with no fetal heart beat,9 cases with pregnancy mass<3 cm,and 11 cases with pregnancy mass≥3 cm.All the patients were diagnosed by B-ultrasound and laparoscopy,and underwent laparoscopic debridement of pregnancy lesions.The amount of intraoperative blood loss,operation time,incidence of complications,changes of human chorionic gonadotropin(HCG)and hemoglobin(Hb)before and after operation,and postoperative pregnancy in the patients were analyzed.Results The operation time of the 20 patients was(78.70±28.78)min,and their intraoperative blood loss was(54.00±39.80)mL.Preoperative fetal heart beat had no significant effect on intraoperative blood loss and operation time(P>0.05).The intraoperative blood loss in the preoperative pregnancy mass<3 cm group was less than that in the preoperative pregnancy mass≥3 cm group,and the difference was statistically significant(P<0.05),but there was no significant difference in the operation time between the two groups(P>0.05).There were no complications such as uterine perforation and peripheral organ damage during the operation in all the 20 patients.The postoperative vaginal bleeding time lasted for(4.45±1.85)days.The time to resume diet after operation was(3.30±0.87)days,and the postoperative hospital stay was(4.00±0.65)days.The levels of HCG and Hb in the patients 2 days after operation were significantly lower than those before operation(P<0.05).Eleven patients had the intention of pregnancy,of which 6 cases(54.55%,6/11)had normal pregnancy again and gave birth successfully.Conclusion In typeⅡunruptured corneal pregnancy,laparoscopic debridement of pregnancy lesions protects the endometrium bett

关 键 词：腹腔镜下妊娠病灶清除术 Ⅱ型未破裂型宫角妊娠 临床疗效 

分 类 号：R714.2[医药卫生—妇产科学]