腹腔镜保留输卵管手术治疗输卵管妊娠56例报告

Laparoscopic tube sparing operation for tubal ectopic pregnancy:Report of 56 cases

目的 探讨腹腔镜保留输卵管手术治疗输卵管妊娠的效果。 方法 回顾性分析 5 6例腹腔镜保守治疗输卵管妊娠的临床资料。 结果 8例因创面出血经电凝止血无效而行输卵管切除术 ,余 4 8例保留输卵管成功 ,其中 3例因持续性宫外孕行MTX治疗一疗程。术后 1～ 2个月 4 7例保留输卵管成功者行输卵管碘油造影 ,患侧通畅 36例 ,通而不畅 8例 ,不通 3例 ;对侧 ( 3例已手术切除 )通畅 34例 ,通而不畅 7例 ,不通 3例。 结论 腹腔镜保留输卵管手术治疗输卵管妊娠在适宜条件下疗效确定。

Objective To investigate the effects of laparoscopic tube sparing operation in the treatment of tubal ectopic pregnancy. Methods Clinical data of 56 cases of tubal pregnancy undergoing laparoscopic conservative treatment were retrospectively reviewed. Results Salpingectomy was required in 8 cases because the electrocoagulation had proven ineffective for the bleeding of operated area, whereas the tube sparing surgery was accomplished successfully in the remaining 48 cases, in 3 of which one treatment course of MTX was administered on account of recurrent episodes. Hysterosalpingography with iodized oil at 1～2 postoperative months in 47 cases receiving conservative surgical treatment revealed that, the involved oviduct was patent in 36 cases, unobstructed but not patent in 8 cases, and obstructed in 3 cases, while the contralateral oviduct (which had been previously resected in 3 cases) was patent in 34 cases, unobstructed but not patent in 7, and obstructed in 3. Conclusions Under proper conditions, laparoscopic tube sparing operation is effective in the treatment of tubal ectopic pregnancy.