异位妊娠经腹腔镜治疗265例分析

LAPAROSCOPY TREATMENT OF 265 ECTOPIC PREGNANCIES

该文总结了 1990年～ 1999年 8月共 2 6 5例异位妊娠患者于腹腔镜下治疗结果 ,其中输卵管切除术 5 5例 ,保守性手术 197例 ,切开取胚胎缝合修补术 15 5例 ,切开取胚胎开窗术 2 5例 ,吸引术 17例 ;镜下注射氨甲蝶呤13例。中转手术 5例 ,镜下注射氨甲蝶呤 3例 ,镜下切开取胚胎开窗术 1例 ,均中转剖腹患侧输卵管切除术 ;1例镜下切开输卵管缝合修补术改为镜下患侧输卵管切除术。要求保留生育功能者 114例 ,有生育要求者 37例 ,宫内妊娠 15例 (80 .84% ) ,足月分娩 10例 ,再次异位妊娠 4例 (10 .81% )。

Objective: To study the laparoscopy treatment for ectopic pregnancy. Method: 265 ectopic pregnancies were treated under laparoscopy in our hospital. Results: 55 cases had salpingectomy. Of 197 conservative operation, there were 155 cases who had linear salpingostomy, 25 patients had salpingotomy without colsure, 17 cases were removed of ectopic trophoblastic tissue, and 13 cases had intratubal methotrexate injection under laparoscopy. Only 5 cases required a subsequent laparotomy. There were 3 methotrexate injection, 1 linear salpingostomy and 1 salpingostomy with suture. 114 patients wanted to preserve their tubal function. Of 37 cases desiring subsequent pregnancy, 15 had an intrauterine pregnancy (40.84%), and 4 had a second ectopic pregnancy (10.81%). 10 cases delivered later. Conclusions: Laparoscopy is the relatively good treatment for ectopic pregnancy.