腹腔镜治疗输卵管间质部妊娠破裂的临床观察

Clinical observation of treatment with laparoscopic surgery for interstitial tubal pregnancy

目的探讨腹腔镜下治疗输卵管间质部妊娠破裂的可行性及安全性。方法将输卵管间质部妊娠破裂、要求保留生育功能的患者62例,随机分成研究组32例和对照组30例,均行异位妊娠病灶清除术,研究组行腹腔镜下手术,对照组行传统开腹手术,术中均应用垂体后叶素及氨甲喋呤,观察两组术中出血量、手术时间、术后肛门排气时间、术后进食时间、下床活动时间、住院天数、术后持续性异位妊娠发生率等情况。结果研究组术中出血量、手术时间、术后肛门排气时间、术后进食时间、下床活动时间、住院天数明显少于对照组(P<0.05),差异有统计学意义,两组术后持续性异位妊娠的发生率差异无统计学意义。结论腹腔镜下垂体后叶素联合氨甲喋呤治疗输卵管间质部妊娠破裂是安全、有效的,可用于输卵管间质部妊娠破裂的治疗。

Objective To investigate the feasibility and safety of laparoscopic surgery for the treatment of interstitial tubal pregnancy rupture. Methods 62 patients of interstitial tubal pregnancy rupture,requiring preserving fertility were enrolled. These patients were randomly divided into study group（ 32 cases） and control group（ 30 cases）,and all patients underwent debridement. Study group underwent laparoscopic operation,and control group underwent conventional open operation. Both hypopnysin and methotrexate were used in two groups. The volume of intraoperative bleedings,operation duration,postoperative anal exhaust time,postoperative eating time,ambulation time,hospital stay,postoperative persistent ectopic pregnancy rate were observed. Results The bleeding volume, operation time, postoperative anal exhaust time,postoperative eating time,ambulation time,length of hospital stay in study greup were significantly less than that of control group（ P 0. 05）. The rate of postoperative persistent ectopic pregnancy had no significant difference between two groups after operation. Conclusion Laparoscopy combined with intra-uterine injection of hypophysin and methotrexate in the treatment of interstitial tubal pregnancy rupture is safe and effective.