腹腔镜下缝扎切开取胚法治疗输卵管间质部妊娠

Laparoscopic Ligation and Resection for Interstitial Tubal Pregnancy

目的探讨腹腔镜下缝扎切开取胚法治疗输卵管间质部妊娠的效果。方法2004年7月～2007年12月32例输卵管间质部妊娠按照不同手术方法分为2组。A组16例,腹腔镜下采用缝扎切开取胚法施行输卵管间质部切除术;B组16例,腹腔镜下采用局部电凝后施行输卵管切除术,比较2组手术时间、术中出血量、术后并发症、术后24h血β-hCG值变化、血β-hCG值恢复正常时间。结果A组手术时间(40±16)min显著少于B组(60±19)min(t=-3.178,P=0.004);A组术中出血量(40±12)ml显著少于B组(95±26)ml(t=-7.644,P=0.000),2组术后24h血β-hCG值变化差异无显著性[(9889±7945)mIU/mlvs(9696±7883)mIU/ml,t=0.068,P=0.946],A组血β-hCG值恢复正常时间(10.1±3.2)d与B组(9.8±2.4)d无统计学差异(t=0.294,P=0.771)。2组均无持续性异位妊娠发生。结论腹腔镜下缝扎切开取胚法治疗输卵管间质部妊娠疗效肯定。

Objective To study the efficacy of laparoscopic ligation and resection for the treatment of interstitial tubal pregnancy.Methods Totally 32 patients with interstitial tubal pregnancy were enrolled into this study.The cases were randomly divided into groups A and B（16 in each）.Laparoscopic ligation and resection was performed in group A,while the patients in group B received traditional salpingectomy to remove the embryo after local electrical coagulation.The operation time,intraoperative blood loss,rates of conversion to open surgery and postoperative complications,the 24-hour change of β-hCG,and the recovery time of β-hCG level were compared between the two groups.Results Compared to the group B,group A had significantly shorter operation time and less blood loss （40±16）min vs（60±19）min,t=-3.178,P=0.004;and（40±12）ml vs（95±26）ml,t=-7.644,P=0.000].The 24-hour change and recovery time of the level of β-hCG were similar between the two groups （9889±7945）mIU/ml vs（9696±7883）mIU/ml,t=0.068,P=0.946;（10.1±3.2）d vs（9.8±2.4）d,t=0.294,P=0.771].Conclusions Laparoscopic ligation and resection is effective for the treatment of interstitial tubal pregnancy.