腹腔镜下输卵管妊娠保守性手术的临床研究

Clinical analysis of tubal pregnancy conservative operation with laparoscopy

目的探讨输卵管妊娠理想的手术方法。方法对2001年8月至2004年12月的输卵管妊娠患者418例进行腹腔镜下保守性手术;1998年1月至2001年7月的输卵管妊娠患者182例进行开腹保守性手术,观察比较两组的手术效果,术后发生持续性异位妊娠的情况,术后宫内妊娠率及重复异位妊娠率。结果腹腔镜组418例中仅1例发生持续性异位妊娠,开腹组182例中有6例(3．3％)发生了术后持续性异位妊娠,两组比较差异有显著意义(P<0．05)。术后宫内受孕情况,腹腔镜组随访216例,宫内受孕138例 (63．9％,138/216);开腹组随访86例,宫内受孕54例(62．8％,54/86);术后再次异位妊娠率,腹腔镜组2．3％ (5／216),开腹组为3．5％(3／54),差异无显著意义(P>0．05)。结论输卵管妊娠保守性手术中腹腔镜手术明显优于开腹手术。

Objective To compare the results of conservative treatment operation for two groups of tubal pregnancy with laparoscopy and laparotomy. Methods We disparted tubal pregnancy patients into two groups： laparoscopy group（418 cases from August 2001 to December 2004） and laparotomy group（182 cases from January 1998 to July 2001）, and evaluated the clinical characteristics,the postoperative incidences of persistent ectopic pregnancy, the rate of intra-uterine pregnancy and the rate of ectopic pregnancy. Results In the laparoscopy group,only 1 case arised the postoperative incidences of persistent ectopic pregnancy. In the laparotomy group,6（3.3 % ） out of 182 arised（ P 〈 0.05 ）. The rate of intra-uterine pregnancy （63.9 %, 62.8 % respectively） and the rate of ectopic pregnancy（2.3 % , 3.5 % respectively） had no difference between the two groups （ P 〉 0.05 ）. Conclusion Laparoscopy has advantage over laparotomy therapy in the conservative operation of tubal pregnancy.