药物杀胚联合腹腔镜保守手术治疗异位妊娠64例分析

Observation of laparoscopic surgery and drug treatment of kill embryos in the treatment of ectopic pregnancy

目的了解在异位妊娠治疗中,药物杀胚治疗后对腹腔镜保守手术的影响及术后恢复的状况。方法回顾性分析62例异位妊娠患者,先予氨甲喋呤(MTX)+米非司酮杀胚治疗1～2个疗程后再行腹腔镜下开窗取胚术或胚胎伞端挤出术,术中观察胚胎组织、出血情况以及术后持续性异位妊娠发生率及妊娠情况。结果输卵管保守性手术全部成功,术中胚胎组织陈旧,创面出血少;无持续性异位妊娠发生;术后宫内妊娠66.7%,再次异位妊娠11.9%。结论药物杀胚后再行腹腔镜保守手术,术中出血减少、增加了保留完整输卵管概率,避免了持续性异位妊娠发生,操作方便,有临床推广价值。

Objective To observe effect of drug treatment to kill embryos after the laparoscopic surgery and the postoperative recovery situation. Methods 62 cases of ectopic pregnancy was retrospectively analyzed by methotrexate （MTX） ＋ mifepristone treatment to kill embryos and laparoscopic fenestration surgery after 1--2 treatments to take out the umbrella side of the embryos. The embryonic tissue,bleeding and postoperative incidence of persistent ectopic pregnancy and pregnancy situation were observed. Results of conservative tubal surgery was successful in all patients with old embryonic tissue,less bleeding wound,no persistent ectopic pregnancy and 66.7 % of postoperative intrauterine pregnancy and l1. 9 % of ectopic pregnancy again. Conclusion Laparo scopic conservative surgery after drug treatment reduced blood loss,increased risk of fallopian tube intact, and avoided the occurrence of persistent ectopic pregnancy. It was easy to operate with clinical value.