输卵管间质部与壶腹部妊娠的比较分析

Comparative Analysis of Interstitial Tubal Ampullary and Fallopian Tubal Pregnancy

目的探讨输卵管间质部妊娠的临床特点及治疗。方法回顾性分析我院2003-01～2012-10间收治的输卵管间质部妊娠患者40例及同期收治的输卵管壶腹部妊娠患者60例的临床资料,并进行比较。结果间质部妊娠组患者在7～8周术前确诊例数18例(45.00%),与壶腹部妊娠组35例(58.33%)相比差异无统计学意义(P>0.05)。间质部妊娠组行腹腔镜治疗13例(32.50%),少于壶腹部妊娠组32例(53.33%),差异有统计学意义(P<0.05),且有4例中转开腹,壶腹部妊娠组无中转开腹病例。间质部妊娠组行输卵管切除25例(62.50%),明显多于壶腹部妊娠组23例(38.30%),差异有统计学意义(P<0.05),但腹腔镜下行输卵管切除术与壶腹部组比较差异无统计学意义(P>0.05)。结论随着检测手段及治疗水平的提高,输卵管间质部妊娠可以得到早期诊断及早期治疗,腹腔镜治疗已不是禁忌,但开腹率及中转开腹率仍高于壶腹部妊娠组,且腹腔镜下行切除输卵管治疗相对风险较小。

Objective To investigate the clinical characteristics and treatment of interstitial tubal ampullany pregnancy.Methods Retrospective analysis and comparative analysis interstitial tubal pregnancy in 40 cases and 60 patients treated with ampullary pregnancy of the hospital from January 2003 to October 2012 are done.Results 18 cases of interstitial pregnancy patients in 7 ～ 8 weeks were preoperatively diagnosed cases(45.00%),and there was not statistically significant difference between 35 cases of ampullary pregnancy group(58.33%)(P >0.05).13 cases in interstitial pregnancy group underwent laparoscopic treatment(32.50%),less than 32 cases in ampullar pregnancy group(53.33%),with statistical significance(P < 0.05),and 4 cases were converted to laparotomy,ampullary pregnancy cases without conversion to open surgery.Interstitial pregnancy tubal resection in 25 cases(62.50%) were significantly more than 23 cases in the ampullary pregnancy group(38.3%),the difference was statistically significant(P < 0.05),but laparoscopic salpingectomy and ampullary groups had no significant difference(P > 0.05).Conclusion With the improvement of detection and treatment,interstitial tubal pregnancy can get early diagnosis and early treatment,laparoscopic treatment is not taboo,but open rate and conversion rate was still higher than that of ampullary pregnancy group,and laparoscopic resection treatment of fallopian tube is in less risk.