两种保守手术联合米非司酮治疗输卵管妊娠临床分析

Clinical Analysis of Two Kinds of Conservative Surgical in Treating Tubal Pregnancy with

目的比较腹腔镜与开腹保守手术治疗输卵管妊娠临床效果。方法将136例有生育要求、符合保守手术治疗条件的患者，按其意愿分为腹腔镜组70例及开腹组66例，术后1—2天常规服用米非司酮预防持续性异位妊娠（PEP），比较两组术中术后情况及术后生殖状态。结果与开腹组相比，腹腔镜组手术时间短、术中出血少、目下门排气及住院时间短，差异有统计学意义（t=3．475、9．259、24．449、18．22，P〈0．01）；血β-HCG恢复正常时间、PEP、术后输卵管通畅率、宫内妊娠率、重复性及持续性异位妊娠两组比较，差异无统计学意义（P〉0．05）。结论腹腔镜保守手术治疗输卯管妊娠手术时间短、术中出血少、术后恢复快，与开腹保守手术有相似的生殖状态，联合米非司酮能有效预防PEP的发生，值得推广。

Objective To compare the clinical effects in treating tubal pregnancy between operative laparoscopy and laparotomy, Methods 136 patients of childbearing requirements, in line with the conditions of conservative surgical treatment, who were divided into opertive laparoscopy 70 cases and laparotomy 66 cases, accoding to their own will. 1-2 days after operation, the patients were required to take mifepristone conventional in the prevention of PEP, comparing two grouPs of patients on and after operations and the later reproductive conditions. Resulta Compared laparotomy grup, there was shorter operative time, less bleeding in operations, shorter anal exhaust time and hospital stay in laparoscopy, whose defferences were statistically signifcant （ t=3.475, 9.259, 24.449, 18.22, P〈 0.01 ）; compared the recover time of serum β-HCG, postoperative tubal patency rate, intrauterine pregnancy rate, repetitive and persistent ectopic pregnancy of two groups, there were no significant difference. Conclusions Surgeries of operative laparoscopy in treating tubal pregnancy, is better than laparotomy on operative time, the amount of bleeding, the postoperative recovery time and similar reproductive status to conservative laparotomy, combined with mifepristone can be effective in preventing the occurrence of persistent ectopic pregnancy, which is worthy of popularization.