异位妊娠的腹腔镜手术治疗73例分析

Treatment of ectopic pregnancy by laparoscopic surgery:A report of 73 cases.

目的 评价腹腔镜在异位妊娠治疗中的价值。 方法 :73例异位妊娠不同阶段 ,分别采用腹腔镜下注射MTX、输卵管伞端孕囊挤出、输卵管线形切开、患侧输卵管切除、卵巢部分切除等手术方法。 结果 本组 73例中 ,输卵管妊娠 70例 ,占 95 .9% ,其中流产型 38例 (5 4 3% ) ,破裂型 19例 (2 7 1% )。除 13例未发生破裂或流产的极早期患者腹腔内无积血 ,其余则分别有 10 0ml～ 3,0 0 0ml的积血。术中出血 :13例注射MTX者仅有注射部位点状渗血 ,其余出血平均 33 7ml(10ml～ 80ml)。手术时间平均6 2 7min(34min～ 4 8min)。

Objective To assess the value of laparoscopic treatment of ectopic pregnancy. Methods Laparoscopic operations were performed,including injection MTX into the tube of ectopic pregnancy,linear salpingostomy,salpingectomy and partial oophorectomy. Results Among 73 cases of ectopic pregnancy,70 cases(95.9%)were confirmed as tubal pregnancy,of which there were 38 cases of tubal abortion(54.3%)and 19 cases(27.1%) of rupture.No blood was found in the abdoment in the cases of unrupture and unhappened tubal abortion,whereas there was 100ml～3,000ml blood in others.There was only spotting in the cases of unrupture and unhappened tubal abortion,and there was 10ml～80ml of bleeding in other cases.The operating time varied from 34 min to 108 min. Conclusions The laproscopic surgery can be chosen as the first method in the treatmentof ectopic pregnancy.