较高水平血β-HCG输卵管妊娠的腹腔镜保守性治疗80例分析

Clinical Analysis on 80 Cases Tubal Prenancy with Higher Level of Blood β-HCG Underwent Laparoscopic Conservative Surgery

目的:探讨较高水平血人绒毛膜促性腺激素(β-HCG>2500 IU/L)的输卵管妊娠行腹腔镜保守性手术的可行性。方法:回顾性分析80例腹腔镜下输卵管妊娠的住院时间、手术时间、术中出血量及术后血β-HCG水平等。结果:80例均在腹腔镜下手术,按术前血β-HCG水平分为两组:β-HCG2500-5000 IU/L者42例,β-HCG>5000 IU/L者38例。比较两组的住院时间、手术时间、术中出血量、术后血β-HCG水平等,两组有显著性差异(P<0.05)。结论:血β-HCG 2500-5000IU/L患者施行保留输卵管手术是安全可行的。而血β-HCG>5000 IU/L输卵管妊娠保守性手术难度较大,术中出血多,术后血β-HCG下降不满意,持续性宫外孕发生率高,术后输卵管功能不良,不宜保留输卵管。

Objective： To study the feasibility of laparoscopic of the conservative surgery for tubal preg- nancy with higher level of human blood of gonadotropins （ β-HCG 〉 2500 IU/L）. Method： A retrospective analysis on 80 cases of laparoscopic tubal pregnancy about the length of hospital stay, operation time, bleed- ing during operation and postoperative β-HCG level. Result： 80 cases were in laparoscopic surgery, divided into two groups according to the preoperative blood β-HCG level： 42 cases with the β-HCG 2500 - 5000 IU/L ,38 cases with the β-HCG 〉 5000 IU/L. There＇s significant difference in the length of time, operation time, peri-operative bleeding and postoperative blood β-HCG level, etc in two groups （P 〈0. 05）. Con- clusion： It is safe and feasible for tubal pregnancy patients with Blood β-HCG 2500 - 5000 IU/L. But con- servative surgical on tubal pregnancy patients with blood β-HCG 〉 5000 IU/Lmore difficult, with bleeding more , postoperative blood β-HCG decline not satisfied, persistent ectopic pregnancy rate is higher, the fal- lopian tube dysfunction postoperative, it is unfavorable to keep fallopian tube.