两种手术途径治疗宫角妊娠临床分析

Clinical analysis of Two Operation Channels to Treat Comual Pregnancy

目的探讨分别在腹腔镜下及经腹手术治疗宫角妊娠的方法。方法我院2003年1月～2008年1月确诊宫角妊娠36例,据病情分为A组:未破裂型16例,破裂型(出血量﹤800 ml)4例行腹腔镜下宫角楔形切除术及同时常规下在腹腔镜监护下行吸宫术;B组:破裂型(出血800～2 500 ml)16例行经腹宫角楔形切除术。结果A组20例患者均在腹腔镜下完成手术,无1例中转开腹,恢复顺利,无1例持续性异位妊娠。B组16例患者及时手术,经输血治疗后均如期恢复,存在2例持续性异位妊娠。A组术中出血(40.2±15.3)ml,B组术中出血(75.2±28.6)ml,A组出血量少于B组(P﹤0.01);手术时间A组(68.2±21.6)min,B组(80.9±20.2)min(P﹤0.05)。结论术前诊断明确,排除手术禁忌,腹腔镜下宫角楔形切除术治疗宫角妊娠是一种有效、安全、经济的方法。

Objective To investigate the method in laparoscopic surgery and the abdominal of the treatment of comual pregnancy. Methods In our hospital in January 2003 - January 2008 confirmed 36 cases of cornual pregnancy, according to the disease, were divided into A group： 16 cases ofunruptured, 4 case of ruptured （hemorrhage 〈800 ml） in laparoscopic surgery of wedge resection and uterine aspiration; B group： 16 cases of the ruptured （hemorrhage 800 - 2500 ml） in the abdominal wedge resection. Results 20 patients in A group completed in laparoscopic surgery, no case of conversion to the abdominal, no case of persistent ectopic pregnancy. 16 cases in group B with timely surgery, were scheduled and recovered by blood transfusion, in which there were two cases of persistent ectopic pregnancy. A group of bleeding （40.2± 15.3） ml, B blood group （75.2 ± 28.6） ml, A Group less bleeding compared to B Group （P〈0.01）; operation time A group （68.2± 21.6） min, B group （80.9 ± 20.2） min （P〈0.05）. Conclusion The clear preoperative diagnosis, rule out surgery counterindication, laparoscopic cor- nual wedge resection for the treatment of cornual pregnancy is an effective, safe and economical method.