腹腔镜异位妊娠保守手术后持续异位妊娠的临床治疗

After Peritoneoscope Extrauterine Pregnancy Conservative Surgery, Continues the Extrauterine Pregnancy the Clinical Care

目的:探讨腹腔镜异位妊娠的保守性手术治疗及PEP的预防。方法:采用连续硬膜外麻醉,腹腔镜下保守治疗输卵管妊娠176例。结果:176例病例中,12例发生PEP(6.82%),其中5例在腹部B超下见盆腔包块直径>2cm,盆腔有少许积液,在B超下引导行局部穿刺注入MTX20mg+0.9%NS5ml,其中1例加服米非司酮,血β-HCG逐渐下降至正常;7例包块<2cm,盆腔无明显积液,一次性口服米非司酮200mg,血β-HCG逐渐下降至正常。结论:MTX及米非司酮是异位妊娠腹腔镜保守术后PEP有效的药物辅助治疗手段。

Objective：Discussion peritoneoscope extrauterine pregnancy conservative surgery treatment and PEP prevention, Method：Uses outside the hard membrane to anaesthetize continuously, under peritoneoscope conservative treatment tubal pregnancy 176 examples.Result：In 176 example cases,12 examples occur PEP（6.82%）,5 examples see pelvic cavity package of block diameter〉2cm under the abdomen ultrasound,the pelvic cavity has the little product fluid,guides a line of partial puncture under the ultrasound to pour into MTX20mg＋0.9%NS5ml,1 example adds clothing Mi Feisi the alkone,the blood β-HCG drops normally gradually to;7 example Bao Kuai〈2cm,The pelvic cavity not obvious product fluid,disposable takes orally Mi Feisi alkone 200mg,the blood β-HCG drops normally gradually.Conclusion：After MTX and Mi Feisi the alkone is the extrauterine pregnancy peritoneoscope conservative technique,PEP effective medicine auxiliary treatment method.