宫腔镜与腹腔镜治疗输卵管间质部妊娠对照分析

Control Analysis of the Effectiveness Between Hysteroscopic Surgery and Laparoscope for the Treatment of Interstitial Tubal Pregnancy

【目的】探讨宫腔镜手术治疗输卵管间质部妊娠（ITP）的可行性和安全性。【方法】回顾性分析本院妇科收治的48例ITP患者，按手术方法不同分成两组，研究组28例行宫腔镜下病灶清除术，对照组20例行腹腔镜下病灶清除手术，比较两组围手术期情况。【结果】宫腔镜组术中出血量（32．6±8．5）mL少于腹腔镜组（83．0±47．8）mL，其差异有统计学意义（P〈0．01）。宫腔镜手术时间〈30．8±7．0）min短于腹腔镜组（53．3±9．1）min，其差异有统计学意义（P〈O．01）。术后住院天数官腔镜组（2．8±0．8）d短于腹腔镜组（6．9±1．1）d，其差异有统计学意义（P〈0．01）。宫腔镜组术后13-hOG恢复正常时间长于腹腔镜组（P〈0．01），但月经恢复时间两组间无显著差异（P〉o．05）。【结论】具有娴熟宫腔镜手术操作技术的手术者行宫腔镜手术治疗ITP是可行的和安全、有效的。

[Objective]To explore the feasibility and safety of hysteroscopic surgery for the treatment of interstitial tubal pregnancy. [Methods]A total of 48 patients of interstitial tubal pregnancy admitted in gyneco- logical department of our hospital were analyzed retrospectively. According to different surgical methods, all patients were divided into two groups. The research group（n-28） underwent focus clearance under hystero- scope, while the control group（n=20） underwent focus clearance under laparoscope. The perioperative situa- tion was compared between two groups. [Results]The intraoperative blood loss in hysteroseope group was less than that in laparoseope group[（32.6±8.5） mL vs. （83.0±47.8）mL], and there was significant difference （ P 〈0.05）. The operation time of hysteroscope group was shorter than that in laparoscope group[（30.8±7.0）min vs. （53.3±9.1）min], and there was significant difference （ P 〈0.05）. The hospital day of hystero- scope group after operation was shorter than that in laparoscope group[（2.8±0.8）d vs. （6.9±1.1）d], and there was significant difference（ P 〈0.05）. However, the time of β-1-tCG returned to the normal level and the recovery time of menstruation in hysteroseope group after operation were longer than those in laparoscope group. [Conelusion]Hysteroscopic surgery operated by surgeons who handle the skillful hysteroscopic proce- dure for the treatment of interstitial tubal pregnancy is feasible, safe and effective.