腹腔镜治疗输卵管间质部妊娠临床分析

Laparoscopic Surgical Skills for Treatment of Interstitial Pregnancy

目的：探讨腹腔镜手术治疗输卵管间质部妊娠的可行性和安全性。方法：回顾性分析本院2002年1月～2005年8月收治的输卵管间质部妊娠23例临床病例资料，其中10例腹腔镜手术（腹腔镜组），13例开腹手术（开腹组）。结果：腹腔镜下10例输卵管间质部妊娠均顺利完成手术，其中包括4例妊娠包块较大者（直径4～5cm），1例术中包块破裂活动出血，无一例中转开腹，且未发生任何术中及术后并发症。腹腔镜组术中出血量（42．2±29．1）ml明显小于开腹组（98．5±47．8）ml，P〈0．01。手术时间腹腔镜组（78．0±11．4）min与开腹组（76．9±17．5）min相近，P〉0．05。术后肛门排气时间腹腔镜组比开腹组明显缩短，P〈0．01。术后住院天数腹腔镜组（4．0±0．8）d比开腹组（5．5±1．7）d明显缩短，P〈0．05。结论：腹腔镜手术治疗输卵管间质部妊娠是安全有效的，娴熟的腹腔镜操作技术及镜下缝合技术是顺利完成手术的保障。

Objective： To evaluate the feasibility and safety of Iaparoscopic surgery for the treatment of interstitial pregnancy. Methods： 10 patients received laparoscopic surgery and 13 patients received laparotomy among 23 patients with interstitial pregnancy from January to August in 2005. Results： Laparoscopic comual resection was performed uneventfully in the laparoscopy group, including 4 cases with larger mass and 1 case with ruptured interstitial pregnancy. The amount of blood loss during operation （42.2 ± 29.1 rnl ） in laprascopy group was significantly less than that （98.5 ± 47.8 ml） in the laparotomy groupml （P 〈0.01 ）. The operating time （78.0 ± 11.4 min）in laparoscopy group was similar with the laparotomy group （ 76. 9 ± 17.5 rain）（ P 〉 0.05 ）. The postoperative exhausting time in lapamscopy group was significantly shorter than that in the laparotomy group（ P 〈0.01 ）. The postoperative hospitalization time （4.0 ±0.8 d）in laparoscopy group was significantly shorter than that（ 5.5 ± 1.7 d）in the laparotomy group （P 〈 0.05 ）. Conclusions： Operative laparoscopy in the patients with interstitial tubal pregnancy can be safely and effectively performed by experienced laparoscopy operators with suturing technology under laparoscopy.