78例异位妊娠的诊断及治疗分析

Diagnosis and treatment of 78 cases of ectopic pregnancy

目的:探讨异位妊娠临床诊断及治疗方法的选择。方法:回顾性分析1997年2月￣2007年3月本院收治的78例确诊为异位妊娠患者的临床资料,根据患者妊娠部位和输卵管、卵巢破损的程度、内出血多少及有无失血性休克症状和患者对生育的要求等综合分析后决定手术方式。分为切除患侧输卵管的彻底手术组(A组)40例和对患侧卵巢和附件造口或整形的保守性手术组(B组)38例。比较A、B两组手术时间、术中出血、术后住院天数、术后排气时间、β-HCG下降时间及住院费用。结果:A、B两组手术时间、术中出血、术后住院天数、术后排气时间、β-HCG下降时间及住院费用比较差异无显著性(P>0.05),B组术后宫内妊娠率65.7%。结论:异位妊娠保守性手术能最大限度地保持生育功能及维持良好的内分泌状态,手术难度不大,可在基层医院推广应用。

Objective：To study the clinical diagnosis and therapeutic method of ectopic pregnancy. Methods：The clinical data in 78 patients with ectopic pregnancy from 1997 to 2007 in our hospital were analysed retrospectively,and divided into energetic operation group（group A,40 cases） and conservative operation group（group B,38 cases） based on the position of gravidity,damaged degree of oviduct and ovary,bleeding volume of internal hemorrhage and procreative requirement.The time of operation,bleeding volume during operation,hospital stay after operation,the time of postoperative exsufflation,β-HCG according to the patient and disease and the cost of hospitalization were compared vespectively.Results：There were no significant differences in the time of operation,bleeding volume during operation,hospital stay after operation,the time of postoperative exsufflation and the cost of hospitalization between two groups.Conclusion：The conservative operation for ectopic pregnancy can maximally maintain the procreative function and endocrinosity. The operation degree of difficulty is tiny,so this method is worth spreading to use in the basic-level hospital.