输卵管妊娠腹腔镜手术后持续性异位妊娠的分析

The Analsis of the Persistent Ectopic Pregrancy After the Laparoscopic Tubal Pregrancy

目的探讨输卵管妊娠腹腔镜手术后持续性异位妊娠(PEP)发生的可能原因,并提出可行性预防措施。方法回顾性分析我院2000年1月至2004年1月收治的要求保留生育功能的未破裂型及流产型的输卵管妊娠198例分为A、B两组,A组86例予腹腔镜输卵管开窗病灶清除术。B组112例在腹腔镜输卵管开窗病灶清除术同时在病灶相应的输卵管注射氨甲喋呤(MTX)10mg,术后监测血β-HCG。结果A组发生PEP4例(4.65%),B组无发生PEP。结论虽然异位妊娠腹腔镜手术后PEP发生率较高,但通过术式的正确选择及药物性预防和医生的警惕性的提高是可以减少甚至避免PEP发生。

Objective Discuss the reason of the persistent ectopic pregrancy (PEP) result from the laparoscopy and bring forth the available measure. Method There were 198 patients who diagnosed as tubalabortion or non-disruptive tubal pregrancy and required keeping potential generandi during 2000.1 to 2004.1. We divided them into two groups (A,86 cases and B,112 cases) randomly. In group A,we treated them with laparoscopic tubal artifistulation and dissection. Besides it,we injected MTX 10mg to the focus fallopian tube and morcitor blood β—HCG after the operation in group B. Results The prevalence of PEP is 4.65% in group A,none in group B. Conclusion Although the PEP prevalence of the laparoscopy is high, according to the right operation mode,drug prevention and the doctors' Vigilance,it's possible to reduce or avoid the happen.