腹腔镜保守手术与化学药物保守治疗输卵管妊娠的效果比较

Comparison on the effect of laparoscopic oviduct-sparing operation and chemotherapy in treatment of tubal pregnancy

目的探讨输卵管妊娠化学药物治疗和腹腔镜保守手术治疗近远期效果的差异。方法103例患者分为腹腔镜保守手术治疗（A组49例）和化学药物保守治疗（B组54例），比较两组住院天数、患侧输卵管通畅率、再次宫内妊娠率及再次同侧异位妊娠率等。结果A组较B组住院天数短[（5．5±2．1）与（18．3±5．4）d，P〈0．05]、3个月后患侧输卵管通畅率高（98．9％与72．1％，P〈0．05）、再次宫内妊娠机会高（55．1％与44．2％，P〈0．05），而同侧再次异位妊娠发生率无差异（24．4％与27．9％，P〉0．05）。结论腹腔镜保守手术治疗输卵管妊娠有疗效高、住院时间短、再次宫内妊娠率高等优点，值得推广应用。

Objective To compare the clinical effect between laparoscopic oviduct-sparing operation and chemotherapy in treatment of tubal pregnancy. Methods A total of 103 patients with tubal pregnancy were divided into two group,group A（49 ease） was treated with laparoseopie oviduct-sparing operation,group B（54 ease） was treated with chemotherapy. The clinical＇ information was compared. Results Group A showed significant differences in shortening the time of hospitalization [ （5.5 ± 2. 1 ） vs （ 18. 3 ±5.4 ） d, P 〈 0. 05 ], increasing the tubal patency rate （98.9% vs72. 1%, P 〈 0. 05 ）, and increasing the chance of re-pregnancy （ 55.1% vs 44. 2%, P 〈 0. 05 ）, when compared to group B. But had no significant effect on preventing the same side tubal pregnancy（24. 4% vs27.9% ,P 〉 0. 05 ）. Conclusion Laparoseopie oviduct-spring operation in treatment of tubal pregnancy has the advantages of rapid therapy, shorten treating time, and higher re-pregnancy chance,it is worth of applying in practice.