腹腔镜输卵管间质部妊娠切开取胚保守性手术24例报告

Conservative Surgery Under Laparascope in the Treatment of Interstitial Tubal Pregnancy: a Report of 24 Cases

目的探讨腹腔镜下输卵管间质部妊娠切开取胚保守性手术的安全性和可行性。方法2012年1月-2014年1月对24例输卵管间质部妊娠施行腹腔镜下输卵管间质部切开取胚保守性手术，在腹腔镜下纵行切开病灶隆起部位，取出孕囊及附属组织，可吸收线连续缝合切口。结果24例均在腹腔镜下完成手术。手术时间（33．5±6．2）min，术中出血量（40．6±9．4）ml。无持续性异位妊娠发生，血β—hCG恢复正常时间（14．2±4．6）d。22例术后输卵管造影显示：患侧输卵管通畅13例，通而不畅4例，不通5例。结论腹腔镜下输卵管间质部妊娠切开取胚保守性手术安全、可行，可部分保留输卵管的通畅性。

Objective To explore the safety and feasibility of conservative laparoscopic salpingotomy and embryo removal. Methods A total of 24 patients with tubal interstitial pregnancy underwent laparoscopic salpingotomy and embryo removal between January 2012 and January 2014. A longitudinal incision was made on the bulge lesions under laparoscope. The gestational sac and affiliated organizations were removed and the incision was continuously sutured with absorption threads. Results The operation was completed in all the 24 patients. The operation time was （33. 5 ＋ 6. 2） min, and the blood loss was （40. 6 ＋ 9.4） ml. No postoperative persistent salpingocyesis occurred. The postoperative serum [3-hCG recovery time was （14.2 ＋ 4.6） d. Postoperative hysterosalpingography showed unobstructed fallopian tube in 13 patients, connected but not patent in 4 patients, and blocked in 5 patients. Conclusion Laparoscopic salpingotomy and embryo removal is safe and effective, with the patency of fallopian tube partly retained.