腹腔镜下输卵管结扎术后宫外孕13例分析

The Study of 13 Cases Ectopic Pregnancy after Tubal Ligation under Laparoscopic

目的探讨输卵管结扎术后宫外孕的原因和预防措施。方法回顾性研究分析我院2012年3月至2014年1月腹腔镜手术中发现的13例输卵管结扎术后宫外孕的临床资料。结果输卵管妊娠发生在壶腹部9例,间质部2例、峡部1例、伞部1例,本组所有患者经过腹腔镜手术治疗,最后均痊愈出院。结论输卵管结扎术后出现宫外孕是由于选择的操作时间不合适、采取不当的术式,以及不当的手术操作等引起的。因此需要选择合适的结扎时间;采用正确的术式,如近端抽芯埋法;手术操作过程必须精细,才能最大程度的避免结扎术后宫外孕的发生。剖宫产术中结扎的患者,因输卵管充血、增粗,结扎部位应尽量选择输卵管峡部,避开血管,如采取曲折断扎法;尽量剪断输卵管,双侧断端分别结扎。

Objective To discuss the cause and preventive measurement for ectopic pregnancy after tubal ligation. Methods Retrospective analysis was made on theclinical information of 13 cases ectopic pregnancy after tubal ligation. Results There were 9 cases tubal ampullary pregnancy, 2 cases tubal interstitial pregnancy, 1 case graviditas tubaria isthmica and 1 case fimbria tube pregnancy .Conclusion Ectopic pregnancy after tubal ligation is due to the Improper operation time, improper surgical choice, and misoperation, etc. Therefore, it is very important to choose a suitable time to ligation and optical protocol to avoid the occurrence of ectopic pregnancy after tubal ligation. And the operation process must also be fine. The position of tubal ligation uring caesarean section should be try to choose isthmus of fetal fallopian tube due to the congestion and wider of fallopian tube, and avoid the blood vessels; try to cut the fallopian tubes, ligation on both sides respectively.